News 7/10/20

Top News

A Health Affairs blog post calls for ONC to start measuring the impact of the interoperability requirements of the 21st Century Cures Act, using these initial metrics:

• The percentage of patients that can gain timely access to their common clinical data set information via an API.
• Whether a given EHR vendor allows patients to write their personally generated data to their systems via an API, as well as the percentage of their provider customers that have enabled at least one of those APIs.
• The percentage of care transitions and referrals in which a summary-of-care record was exchanged via API.
• The number of third-party apps that can connect to each EHR, along with the number of apps that are actually being used by patients and providers.
• The EHR vendor’s availability and provider’s use of an API that supports bulk data transfer.
• The number of information blocking reports on ONC’s website by actor as well as the resulting determination of each complaint

Reader Comments

From Tele Say What?: “Re: telemedicine. The number of visits are dropping, which does not make sense after everyone said COVID experience would make it the standard.” It’s a good time to cynically remind everyone to follow the money since healthcare is not a consumer-driven or even a clinician-driven industry. Stacking up patients in a long hall of always-filled exam rooms is not only more efficient for the provider, it supports upselling opportunities that can’t happen over a video connection. Patients also feel shortchanged if their visit doesn’t result in a prescription or an order for lab or imaging, which presents telehealth with the classic last-mile problem. Yet another issue is that while coronavirus may have temporarily forced bricks-and-mortar providers to send patients to national telemedicine practices who have their own doctors, those providers aren’t about to permanently give up their brand identity and the recurring revenue stream that each patient represents. Buildings, people, and human contact are differentiators that keep patients happy and profitably captive. The pandemic has proven that healthcare, education, and work life can be temporarily shifted online out of necessity, but it has not proven that the virtual alternative is ideal or likely to be sustained.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor eSolutions. The Overland Park, KS company offers best-in-class Medicare and Multi-Payer revenue cycle management, workflow automation, and analytics that help providers get paid quickly and accurately. Its 1,000-plus hospital and health system customers see a 20% reduction in problematic claims in the first 30 days and a 22% reduction of days in A/R within six months. The company processes 164 million claims annually, connects directly to 5,500 payers, and completes 500 million eligibility transactions annually with the fastest response time. It has racked up a 95% customer retention rate over in its 20-year history. ESolutions just announced that its Medicare electronic submission of documentation tool supports CMS’s new requirement for obtaining prior authorization for five types of surgery in hospital outpatient departments. CEO Gerry McCarthy’s first job out of college was in health IT and he’s still here nearly 30 years later with an impressive track record of leadership and company success. Thanks to eSolutions for supporting HIStalk.

I asked some folks to help me put together a media kit for companies that are interested in sponsoring HIStalk and probably think twice after seeing the primitive one I unskillfully cobbled together years ago. There’s a link on the top menu.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Analytics vendor Health Catalyst will acquire Healthfinch, which automates physician EHR workflow. SEC filings indicate a purchase price of $40 million in cash and shares.

Doctor on Demand raises $75 million in a Series D investment round that brings its total funding to $236 million.

Truepill a $25 million funding round and the launch of an integrated telemedicine service that will leverage the company’s in-house EHR. The B2B online pharmacy powers fulfillment for brands like GoodRx, Nurx, and Hers.

For-profit Cancer Treatment Centers of America, which operates five hospitals and five outpatient centers, is evaluating buyers who appear willing to acquire the company at a valuation exceeding $1 billion. Six potential bidders are involved, insiders say, and two of them are private equity firms that are teaming up with huge, not-for-profit health systems (that is certainly interesting). The company started out in 1988 by embracing an out-of-network model for out-of-state residents, but has moved to an in-network model with health system partnerships.

Scotland-based charge master and cost management systems vendor Craneware reports $71 million in annual sales, the same as last year even though revenue took a Q4 hit due to COVID-19’s effect on its US customers. EBITDA for the year was up $500,000 to $24.5 million.

Sales

• Peninsula Regional Medical Center (MD) will implement tele-neurology software and services from SOC Telemed.
• SCL Health (CO) selects patient access and provider data management software from Kyruus.
• Philips signs a 10-year, $100 million contract with the VA to expand development of its Tele-Critical Care Program.

People

Silver Cross Hospital (IL) promotes Teresa Andrea, MSHA, RN to VP/CIO.

Bryan Humbarger (AliveCor) joins digital health vendor Eko as SVP, commercial.

Appriss promotes Krishnan Sastry to president and CEO.

The Chartis Group promotes Shawna Schueller to VP of practice operations.

Michele Morton, MS, RN (SCIO Health Analytics) joins HealthMyne as chief marketing officer.

Reimbursement software vendor Alpha II hires Todd Doze, MBA (TransUnion) as CEO.

Announcements and Implementations

The VA launches the Veterans Data Integration and Federation Enterprise Platform using HealthShare data aggregation software from InterSystems.

After a pandemic-induced two-month delay, University Health System in San Antonio will go live on its $170 million Epic project this weekend.

Henry Schein Medical integrates its VisualDx clinical decision support system with Medpod’s telemedicine solutions, for which it is the exclusive distributor.

KLAS looks at bidirectional interoperability between smart IV pumps sold by BD and ICU Medical and EHRs from Cerner and Epic. ICU has 26 organizations live on interoperability and offers strong project guidance, while BD’s 104 live organizations benefit from standardized implementation but don’t always get help with non-standard problems. Epic and Cerner users wish they would make smart pump interoperability a priority with more timely updates, better documentation and verification workflows, and actionable reports, with the sites that are happiest being those who use their own employees to drive improvements and write reports.

Government and Politics

The VA issues an RFI for a robotic process automation tool that can help import external patient documents into its EHRs (both VistA now and Cerner later). The VA has suffered from a huge backlog of external documents since 2014, when veterans were allowed to seek care outside the VA and those external providers often provided only paper copies of the resulting patient records. The VA is looking for a system that can handle internal folders, email, fax, paper, electronic exchange, and API access to its referral management system.

COVID-19

It’s like COVID déjà vu from March, as the country’s many hotspots are one again reporting PPE shortages, lack of testing supplies, long delays in receiving test results, and lack of available ICU beds.

Arizona reported 4,000 cases and a shocking 35% test positivity rate as the US reported more than 60,000 new cases on Wednesday. Florida reported 9,000 new cases, a 19% test positivity rate, and 120 new deaths. Hospitalizations have more than doubled over the past four weeks in several states, including Texas with 4.8 times the previous number and excluding Florida, which does not report hospitalizations. Mississippi says five of the state’s largest hospitals, including University of Mississippi Medical Center, have no available ICU beds.

PPE shortages are forcing neurologists, cardiologists, and oncologists to leave their offices closed and their patients without care. AMA President Susan Bailey urges the White House to invoke the Defense Production Act for PPE and to develop a coordinated national strategy. Caregivers are being ordered to see COVID-19 patients even though no N-95 masks are available and a Houston hospital has told its doctors to reuse single-use masks for up to 15 days.

Sacramento County, CA closes five COVID-19 testing sites because they can’t get basic test supplies. They’ve asked Quest Diagnostics for help, but the company says it is already at capacity. The county says that’s OK anyway since it’s taking 8-9 days to get results back from tests that are perform several days into the suspected illness, making testing pointless – someone with a known positive result would be quarantined for just 14 days, meaning they would complete their isolation (assuming they do it) before seeing their results.

Vice-President Pence says CDC it will soften its just-published school opening guidelines after President Trump scolded CDC on Twitter for being too tough, then threatened to cut off funding for schools that don’t reopen by fall. CDC Director Robert Redfield, MD later clarified, however, that CDC won’t change the recommendations, but instead will provide additional guidance.

Other

We should do this in the US. Volunteers at Glasgow, Scotland’s 50-year-old, donation-supported charity Hospital Broadcasting Service work from home 24 hours per day playing music, offering friendly talk, and dedicating songs to patients that they or their love ones have requested by text message or email. Listen live and you might hear some surprisingly contemporary music as I did. On-demand video streaming, podcasts, and generic satellite radio leave me feeling disconnected with the world, which is nice sometimes but not always, and it must be worse when confined alone in a hospital bed with too much time to assume the worst.

Sponsor Updates

• Arcadia’s population health platform earns HITRUST CSF Certification for data security.
• MobileHelp adds MDLive’s telemedicine service to its personal emergency response system for home-based patients.
• Healthfinch publishes a new case study, “Increasing Centralized Capacity for Prescription Renewal Requests.”
• Swedish software and services vendor TietoEvry extends its collaboration with Hyland Healthcare for a best-in-class solution for digital pathology.
• CareSignal publishes a new case study, “How STRIDE FQHC Increased Engagement and Chronic Condition Self-Management Among Medicaid Patients to Prepare for Value-Based Care.”
• Kyruus obtains recognition from Avia for its enterprise-wide patient access platform.
• Wolters Kluwer Health announces that Clinical Effectiveness CEO Denise Basow, MD has been ranked among the Top 25 Women Leaders in Healthcare Software of 2020.

Blog Posts

• 11 best practices for operational efficiency and cost reduction with Google Cloud (Google Cloud)
• HAS 20 Virtual: Reimagining the Healthcare Conference (Health Catalyst)
• A picture is worth a thousand words: The role of photography in patient care – Part 1 (Hyland)
• Payers: How to Scale SDOH Across Lines of Business and Demographics (Imat Solutions)
• Healthcare Supply Chain: PAR vs. Perpetual Inventory Systems (Impact Advisors)
• How to avoid security breaches and malicious attacks (Infor)
• High-Performing EHR Training Teams: Coaching for Success (Optimum Healthcare IT)
• How Primary and Specialty Care Practices Can Recover from the Financial Burden of COVID-19 (InstaMed)
• Is COVID-19 the Burning Platform We Need to Move to Value-Based Care? (InterSystems)
• Untapped Potential: Telehealth in Rural and Underserved Communities (PMD)
• COVID-19 and Children’s Healthcare: Key Takeaways from Kyruus’ Virtual Access Forum (Kyruus)
• Building Brand Confidence Through Physical Therapy Marketing in 2020 (MWTherapy)
• Difficult Decisions: How Adversity Can Strengthen Identity (Netsmart)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 7/8/20

Top News

A new KLAS report that looks at advanced users of clinical communications platforms finds that Epic, Halo, and TigerConnect have the greatest breadth of workflows; PerfectServe and Telmediq have fewer workflows and are more widely used in inpatient settings; and Cerner, Hillrom (Voalte), Mobile Heartbeat, and PatientSafe Solutions focus on inpatient settings and have less use in outpatient.

Cerner and Epic have tight integration with their own EHRs, as Epic Secure Chat provides fully embedded functionality and Cerner offers CareAware Connect Communications as a separate app.

Telmediq, PerfectServe, Halo Health, and Vocera top the list for contacting physicians based on their schedules.

The most commonly achieved outcomes among advanced users are reduced phone calls, improved patient satisfaction or outcomes, more efficient workflows, and replacement of SMS messaging with HIPAA-compliant asynchronous communication.

Users conclude that communications platforms are expensive but worth it; success requires focusing on the patient care team and integrating with the EHR; connecting with the right people requires an enterprise scheduling approach; and health systems should choose a vendor based on their ability to develop rapidly rather than those who claim to have it all today.

Reader Comments

From Smallie Biggs: “Re: sales. Aren’t strategies and desires like this what we are trying to eradicate in this industry? Everyone wants to make money, but why would someone who leads a healthcare practice publish a book that does not align with the focus of delivering solutions to healthcare clients?” John Orton, US healthcare practice leader for Avaya, publishes “Super Seller Secrets Exposed,” in which he explains how he has “been able to collect huge commission checks, but he has also traveled the globe and continues to live a Super Seller lifestyle.” I will generously assume that John is no different than other authors of sales and motivation books who thrust hyperbole in the faces of prospects to convince them to press the “buy” button (he’s a Super Seller, after all). Those of us without sales experience may find healthcare sales unsavory, but I’ve learned to accept that while it’s obviously the salesperson’s job to convince you to buy something, they aren’t necessary unethical connivers who exert their will over health system people using Jedi mind tricks (unless they sell for a drug company, in which they probably are). In fact, having been on the receiving end of endless sales pitches that were made to my health system peers, I was more frustrated by their behavior than that of the salesperson since their gullibility and need to feel important made them an easy mark. John has worked for the same company for 10 years, which suggests that he’s not a wandering gunslinger who is burning bridges behind him. I am fascinated but ignorant of how salespeople move prospects along to contract signing in healthcare, especially with regard to prospect psychology, and the industry richly values those folks who can move iron. Somehow I doubt that reading John’s book will endow marginal salespeople with the superpowers that are required to cavort with John and his Super Seller compadres, but those who are destined for sales success are irrationally optimistic and will thus probably buy a copy in hopes of sharpening their saw.

HIStalk Announcements and Requests

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Sales

• OptimizeRx announces two sales of its point-of-care prescription messaging system for patient affordability, adherence, and care management to unnamed clients.

People

Tele-nephrology platform vendor TeleNeph hires Ron Kubit (Sopris Health) as CEO.

Announcements and Implementations

LiveProcess announces the release of Aware, a real-time virtual situation management platform.

Government and Politics

The White House’s 2021 budget request includes $105 billion for the VA, including $4.9 billion for IT and $2.6 billion (versus $1.5 billion this year) for its Cerner project.

COVID-19

The New York Times had to sue CDC under the Freedom of Information Act to force the federal government to provide COVID-19 case data broken out by race, ethnicity, and county of residence, which confirms that Latinos and African-Americans are three times as likely to be infected as their white neighbors and twice as likely to die. These disparities cross state and regional lines. The Times notes that race and ethnicity data are missing from more than half of the 1.5 million cases CDC has documented, its information is current only through the end of May, and it does not included the suspected source of infection. CDC says it has asked state and local agencies to collect and report this data, but cannot force them to do so.

The disconnect between increasing COVID-19 case numbers and decreasing death rates is being attributed by some experts to Simpson’s Paradox, where conclusions that are drawn from big datasets can hide insights that would be visible within smaller data clusters. Trends in COVID case counts, positivity rates, hospitalizations, and death rates may be dramatically observable at the city or county level but can get buried when looking only at counts for a state or the entire US. Expert data review will find insight that computational methods will miss. The common example of Simpson’s Paradox is the batting averages of two baseball players, where Player A has a higher batting average than Player B every month, yet Player B ends up with a higher average for the whole season. The COVID example is that low numbers in the former hotspots in the Northeast are making the US look better as a country when in fact the pandemic is burning out of control in specific areas in the form of regional outbreaks, which will have a strong impact on local resources.

A large seroprevalence study in Spain finds that despite widespread infection there, the country is not even close to herd immunity, if that even matters since nobody knows whether antibody presence indicates protection from reinfection.

Brazil President Jair Bolsonaro, who has downplayed COVID-19 dangers and ignored public health advice, tests positive and starts taking hydroxychloroquine.

People who go to the hospital ED with COVID-19 symptoms are being stuck with huge bills by some insurers if they leave without being tested due to not meeting the hospital’s criteria or not having tests available.

Arizona reports that 3,300 patients are hospitalized with COVID-19 in the state, 870 of them in ICUs that are at 89% capacity. Tucson hospitals are reportedly sending new patients to Phoenix, San Diego, Las Vegas, and Albuquerque. Houston hits a record of COVID-19 hospitalizations for the fifth time in the first seven days of July so far, with 981 in the ICU, Texas Medical Center at 103% of ICU usage, and 47% of ICU patients there due to COVID-19.

Former CMS Administrator Andy Slavitt summarizes his conversations with multiple scientists who have reviewed early data from prospective vaccines:

• Preliminary vaccine data looks good, but early versions may work more like flu vaccine in offering modest protection for some people for some unknown period of time. They expect iterative improvement as new vaccines are brought to market.
• Monoclonal antibody therapy as a COVID treatment may be more promising than vaccines for prevention, and clinical trials for it can be completed easier and and faster.
• The likely future state is that we will see reduced COVID-19 lethality but without eradication as a gradually occurring “new normal” with few big developments along the way.
• Many deaths will occur before a vaccine is available, but even the early versions are likely to be safe and effective to some degree.

The White House notifies Congress and the UN that the US is withdrawing from the World Health Organization, effective July 6, 2021.

HHS Secretary Alex Azar says in a panel discussion about reopening schools that, “Healthcare workers don’t get infected because they take appropriate precautions. They engage in social distancing, wear facial coverings.” He didn’t mention that thousands of healthcare of workers have tested positive for COVID-19 and at least 600 have died.

My young relative still hasn’t received her COVID-19 test results 10 days after being tested after potentially being exposed at work. Her father, who is a doctor, started having symptoms this morning and he is now waiting on his test results while not practicing medicine. I can see why experts say it’s too late to implement contact tracing here since we’ve let our outbreak run wild and we are once again regionally running out of testing supplies, watching lab backlogs grow, and running out of hospital capacity. The virus loves our lack of national planning and coordination. 

Other

A startup in China develops a “pulse fax machine” that sends a user’s pulse reproduction to practitioners of Chinese medicine, who uses pulse palpation to assess health and diagnose problems. The company hopes to sell the system to 50 hospitals in the next year. It also uses it in its own chain of private clinics and distributes it via a hospital systems vendor. The company is Maizhiyu, which means “the language of the pulse.”

Sponsor Updates

• Glytec partners with ThunderCat Technology to make Glytec’s Glucommander insulin management software more widely available to VA facilities.
• CI Security will integrate its Critical Insight Managed Detection and Response offering with solutions from Internet of Things and Internet of Medical Things security vendors Order, Medigate, and Cylera.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, releases a new Clinical Concepts in Obstetrics Podcast, “A Preeclampsia Case Study.”
• Diameter Health will lead a roundtable discussion, “Paper Killers: Innovative Solutions in Digital Health,” during the virtual NCQA Digital Quality Summit July 23.

Blog Posts

• 3 Ways to Optimize Epic Training (314e)
• Best Practices for Building a Telehealth Team Now (Access)
• Hitchhiker’s Guide to Managing a Sustainable Patient Mix (AdvancedMD)
• Enterprise Imaging Goes Live at AdventHealth (Agfa HealthCare)
• A conversation with Tammy Combs and Melissa Potts of the American Health Information Management Association (AHIMA) (Artifact Health)
• The State of Medication Access (CoverMyMeds)
• 8 Most-Asked Questions About Employee Health Screening Tools (Dina)
• ‘The new system:’ How will healthcare organisations navigate COVID-19 and beyond? (Elsevier Clinical Solutions)
• How to Digitize Your Front Office (EClinicalWorks)
• Interoperability Rules are Delayed: Why That’s Good News and Bad News (Ensocare)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 7/6/20

Top News

Medical informatics pioneer G. Octo Barnett, MD died June 30 at 89, according to colleagues.

Massachusetts General Hospital hired Barnett in 1964 to implement a hospital information system on a time-sharing computer, from which the Laboratory of Computer Science was founded. Barnett was director of the lab until his retirement in 2012.

Barnett, who referred to himself as a “farm boy” and “country doctor” from his upbringing in Alabama, was involved with the development of COSTAR, one of the first ambulatory EHRs, and DXplain, a diagnostic decision support system. He led the LCS group that in the mid-1960s developed early versions of the MUMPS programming language and Cache’ database, which are still used by vendors such as Epic, Meditech, and InterSystems and formed the foundation of the VA’s VistA. He was a founder and original member of AMIA.

Joan Ash and Dean Sittig interviewed Barnett in 2004 as part of a medical informatics oral history project. It is a fascinating read. An excerpt from his advice for informatics fellows:

Get to know the people in the field. Listen and to learn from them. Go to meetings and try to be open to a whole variety of different viewpoints and projects. Don’t get discouraged too easily because there’s going to be some bad times. Hope that in some sense, you’re lucky, that basically things work at the right time and place, because it is very much fortuitous circumstances. It’s very much a time for questioning. I could certainly never have planned my career on any sort of rational, “OK, here’s what I’m going do: Step 1, Step 2, Step 3 … “ You can’t demand a hope for serendipities. That’s the problem, you can’t plan for them. I suppose the best you can do with serendipity is be aware it’s an opportunity when it’s your time.

Reader Comments

From Epic Watcher: “Re: Epic. All these headlines from unfortunate internal emails to pulling employees back to campus. You haven’t provided many thoughts about this.” I’m not an Epic employee, so I’m not all that interested and have no basis on which to opine. They can run the company however they like, and employees and customers are free to act accordingly. My only observation is that Epic has no problems attracting and keeping employees and their industry dominance speaks for itself. I don’t think the company is known for crowdsourcing its strategy and tactics to insight-blessed cheap-seaters .

From HIT CEO: “Re: HIStalk. Thanks for what you’re you’re doing. You have literally changed the industry for better and for good. There aren’t that many people that you can isolate, but what you’ve done with your site, all the way back to the early 2000s, is really fascinating, and seeing the way it has evolved is kind of cool. It hasn’t always been flattering to companies I’ve worked for, but that doesn’t matter because it gives a voice to people.” Thanks.

HIStalk Announcements and Requests

The good news for conference organizers is that most poll respondents think they will return to some semblance of in-person normalcy, but the bad news is that they think it will take years to do so. 

New poll to your right or here: Is it OK to fire an employee for off-work actions or social media posts for which no legal charges are filed?

It has been more than a week since my young relative was tested for COVID-19 after potentially being exposed at work. She still has not received her results and her family (including a doctor) are anxious about how to conduct their lives meanwhile and what will change for them if her results are positive. We aren’t going to make much of a dent in this pandemic if we can’t fix the simple logistics of testing for it and reacting quickly to positive results.

We streamed “Hamilton” on Friday and it was spectacular, right down to playing the Roots over the closing credits. Related to it is the best health IT video ever, Mary Washington Healthcare’s self-introduction to Epic from 2017 that featured “Hamilton” inspired music and costumes that are appropriate to their historical location of Fredericksburg, VA.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Montreal-based patient scheduling and waiting room management software vendor Chronometriq acquires Health Myself, a Toronto patient portal startup.

People

Allegheny Health Network names John Lee, MD (Edward-Elmhurst Health) as SVP/CMIO. He replaces Robert White, MD, who is retiring.

COVID-19

COVID-19 test positivity rates continue to increase, especially among young adults, leading to the near certainty of wider spread and increased hospitalization and death weeks down the road. New US cases were at 57,000 on Friday and total deaths are over 132,000.   

North American retail traffic is slowing after weeks of strong gains, suggesting that consumers are choosing to limit their exposure regardless of local, state, and federal government policies. It’s down 50% from this time last year.

The US-Mexico border closes to visitors due to COVID-19 concerns, only this time it is Mexico that is preventing Americans from entering Sonora, which is on the other side of the wall from infection-ravaged Arizona. Meanwhile, England joins the EU in trying to keep visitors from the US out, waiving its mandatory 14-day quarantine for visitors from 50 countries. That policy is still more generous than that of the EU, which banned American travelers entirely last week.

Premier calls for national stockpiling standards after its survey finds that 90% of healthcare providers as well as states are months-long quantities of masks, gowns, and test kits, creating product shortages and directing supplies away from frontline caregivers in the absence of a national strategy.

Houston doctors say hospital EDs are sending patients with obvious COVID-19 symptoms home without testing them, reserving testing for patients who meet the criteria for immediate admission. A Memorial Hermann ED doctor says hundreds of likely cases are sent home from its 17 EDs without testing because of concerns about the availability of supplies.

In India, low-cost ventilator manufacturer AgVa Healthcare is accused by former employees of manipulating its software to show that patients were receiving more oxygen than they actually were. One hospital reported significant differences between the device’s FiO2 display and patient response, with ventilated patients experiencing restlessness, tachypnea, and sweating. Another hospital rejected the company’s ventilators, but eventually accepted them only as backups to their ICU-grade counterparts. AgVa Healthcare says the accusations are misleading, as its ventilators were tested on actual patients in both hospitals following these reports and the hospitals agreed that they worked as expected.

A research institute in South Korea develops a robot that performs COVID-19 nasal swabs as controlled by a remote technician. It includes a live video connection and force feedback for the operator, who is not exposed to the patient during the process.

This is an epidemiologist’s nightmare, as LA residents flee their closed restaurants, bars, and beaches for less-restrictive San Diego in moving a lot of virus around and increasing the chances of another stay-at-home order. Unfettered travel should come with a free tee shirt that says, “My neighbor took a road trip and all I got was this lousy coronavirus.” My suspicions are that viral spread on beaches is minimal, but it’s the bars and restaurants that are involved in beach trips that create a COVID Petri dish.

Other

Chicago’s Roseland Community Hospital loses telephone and Internet service for more than 24 hours when a car crash brings down the connectivity of broadband provider Wow and the hospital’s failover to cell phones didn’t work.

Sponsor Updates

• Spok publishes an e-book titled “The link between the quadruple aim and improved clinical communications.”
• VentureFizz’s Lead(H)er series features PatientPing Chief People Officer Tiffany Mosher.
• RxRevu reaches 100,000 prescribers and exceeds 10 million transactions through its real-time prescription benefit solution in 2020.
• SymphonyRM releases a new video, “HonorHealth’s AVP Healthcare Marketing on Growth and Loyalty.”
• Visage Imaging makes the latest version of its Visage 7 Enterprise Imaging Platform available.

Blog Posts

• Imbio lung AI models support lung disease diagnosis and care via Nuance AI Marketplace (Nuance)
• Plan a Telehealth Strategy for the Long Run (Pivot Point Consulting)
• Designing Scalable Love (PMD)
• Five Years of Redefining the Storage Industry (Pure Storage)
• Three Questions with Sandy Dunn, CISO at a Large Health Insurance Provider in Idaho (SailPoint)
• The link between the quadruple aim and improved clinical communications (Spok)
• EMPI – The Lightweight Solution You’ve Been Looking For? (Summit Healthcare)
• Offering Expertise, Appreciation and Commitment to Those on the Virtual Front Lines (Surescripts)
• Why Cognitive Bias is Ruining Your Clinic’s Outcomes Data Quality – and How to Fix it (WebPT)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 7/3/20

Top News

Private equity firm TPG is considering the sale of post-acute care software vendor WellSky at a potential valuation of $3 billion.

TPG acquired Mediware from Thoma Bravo in early 2017, then renamed it to WellSky in September 2018.

Mediware was formed in 1980 with a focus on blood and pharmacy management solutions. It went public in 1991. Thoma Bravo took the company private in 2012 for $195 million.

Reader Comments

From Lab Matters: “Re: more existential writing style issues. EHR or EMR?” The term EHR is aspirational marketing-speak for the purely imaginary technology that contains all of your provider’s health information, your own observations and narrative, health alerts and reminders, and your health and wellness practices and purchases, all happily interoperating in real time from all data sources (including wearables) to allow an individual to monitor themselves and share their information with anyone they like as an overall picture of their health, a tiny part of which involves provider visits. What we actually have an EMR, which is an electronic but siloed version of a specific provider’s paper chart that records the episode information that clinicians need to send bills. Meaningful Use rechristened decades-old EMRs to EHRs provided they met easy, questionably relevant certification requirements, causing marketing people to wet their pants in anticipation of lipsticking their poorly selling EMR pigs for doctors to ride to the taxpayer trough. I still call it an EHR even though I’m violating my principal of not using terms incorrectly just because everybody else does. Every encounter I’ve had in hospitals and medical practices involved technology that barely met the definition of EMR, much less EHR.

From Mr. T: “Re: Baylor, Scott & White Health. The largest not-for-profit health system in Texas completed their Epic deployment with a go-live on 6/27 at their seven remaining non-Epic hospitals. This completes a multi-year rollout to standardize all BSWH clinics and hospitals on Epic and displaces Allscripts at the 13 hospitals that were the former Baylor Healthcare System.”

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Sales

• OU Medicine and OU Health Sciences Center (OK) choose Optimum Healthcare IT for their Epic implementation.

People

Anesthesiologist Lee Fleisher, MD joins CMS as chief medical officer and director of its Center for Clinical Standards and Quality.

Announcements and Implementations

Intermountain spinoff Castell implements analytics from Arcadia to help its provider, payer, and ACO customers transition to value-based care.

After its investment news last month, QGenda announces GA of Insights, analytics that aggregate scheduling and labor data across departments for greater visibility into provider capacity and availability.

Children’s of Alabama implements virtual desktop and EHR infrastructure from Pure Storage.

Health Catalyst offers Care Management Suite, a set of analytics-based apps designed to help providers with patient risk stratification, enrollment, and program management.

Government and Politics

The FCC adds nearly $200 million to 2020 funding for its Rural Health Care Program, which has helped providers in remote areas leverage broadband networks for telemedicine during the COVID-19 pandemic.

COVID-19

The outbreak continues to careen out of control as the US surpassed 50,000 new cases in a single day for the first time on Wednesday, with a national positivity rate of over 7% even with higher testing numbers. Florida reported more than 10,000 new cases on Thursday. Arizona reported more than 3,000 news cases with a 25% positivity rate. The county with highest number of new cases per 100,000 population is in East Carroll Parish, LA, with 194 versus the national average of 7. Florida does not publish hospitalization and death counts, but Arizona’s daily deaths are continuing their sharp climb.

Good advice to state governors from former FDA Commissioner Scott Gottlieb, MD: focus on functions that are critical for keeping the economy going and society functioning rather than “congregant settings inside that are purely entertainment” that should be closed. He says he would prioritize getting schools back open.

More than 40 high school principals who attended an in-person school leadership meeting in California are quarantined after one attendee who wasn’t having COVID-19 symptoms at the time tests positive days later. 

Young people in Alabama are throwing COVID-19 parties, urging infected people to attend to intentionally spread coronavirus to the others. Organizers are offering a cash prize for the first attendee who gets infected.

The NBA reports that 25 of its 351 players have tested positive since June 23, plus 10 of 884 team employees.

The White House plans to implement pooled testing by the end of the summer, where portions of 5-10 samples will be pooled into a single sample, and if it tests positive for COVID-19, the retained amount of the individual samples from the batch will be individually tested to identify infected individuals. Experts wonder why the US hasn’t already implemented that strategy already given its low cost, preservation of testing capacity, and success in other countries such as China, Germany, and Israel. CMS has ruled that pooled tests are not diagnostic and thus can be performed by any lab, but retesting samples from a positive batch is considered a diagnosis and can be performed only by certified labs, adding a delay of several days. Pooled testing isn’t practical in situations where positive results are common, such as in meatpacking plants or states whose infection is rampant.

Former CDC Director Tom Frieden, MD, MPH says that most US testing isn’t much good because it takes days to receive results, people aren’t isolated in the meantime, and contact tracing isn’t being employed to warn contacts quickly.

A young relative of mine was notified that her restaurant co-worker had tested positive for COVID-19 and thus my relative needed to be tested. This was last weekend, and she still hasn’t received her results five days later. I didn’t ask if she has been isolating while waiting to hear whether she is infected, but studies have shown that most people don’t. Tom Frieden is right – we’ll get a ton of spread from people who are tested but waiting for results, and that’s not even counting the several pre-symptom days where they were shedding virus without knowing they were infected.

Other

Bloomberg questions the health IT vendor rating methods of Black Book Market Research, which they say (a) is funded by vendors despite claims of independence; (b) conducts a huge number of surveys despite being a tiny company and thus is more like Yelp than J.D. Power, and (c) published two conflicting EHR surveys in which it first declared Cerner to be the VA’s best choice for meeting President Trump’s VA-related health issues, then shortly after named Allscripts the top EHR vendor (in Black Book’s defense, they were clear about applying different criteria, although naming Allscripts as #1 vendor was indeed odd). The scattershot Bloomberg article claims that Black Book published bios of fake executives, but I think that’s because a development website is visible online that I suspect was mocked up from random LinkedIn headshot grabs (including one person who is pictured twice under different names) but that was never on the production site from the web caches that I checked. It’s really a lot of nothingness – try to extract a list of factual bullet points as I did and you’ll see that the story mostly just throws unrelated items against a wall on which none stuck.

The advent of drive-through COVID-19 testing sites may be giving rise to drive-through clinics. A global architecture firm has designed such a facility for hospitals that are hoping to attract outpatients back with convenient, contamination-free appointments. Two Northeast facilities have expressed interest.

Sponsor Updates

• Halo Health will co-present with Atrium Health during the virtual AWS Healthcare & Life Sciences Web Day July 9.
• The Orange Chair Podcast features Hyland VP of Product and Strategic Planning Scott Dwyer.
• Medhost President Ken Misch discusses his personal health journey and the future of rural healthcare on the A Second Opinion Podcast.
• NextGate publishes a new white paper, “Patient Privacy and Data Governance in the Era of COVID-19.”
• Redox partners with Vonage to offer providers private, embedded, and customizable video capabilities; and the ability to build apps; share health data, and securely connect with patients and other providers.
• CarePort Health shares the success Henry Ford Health System has had using its care coordination technology to safely transition patients from the hospital to post-acute care.

Blog Posts

• 5 Reasons Why Providers Need Electronic Support for Glycemic Management (Glytec)
• How the Google AI Community Used Cloud to Help Biomedical Researchers (Google Cloud)
• Digital Transformation: Lessons Learned from Retail (The HCI Group)
• 2021 E/M code documentation: It’s the end of the world, and I feel fine (Nordic)
• What Health Systems Need to Know About COVID Relief Funding (Health Catalyst)
• The Right Mix: Assembling a Prescription Renewal Protocol Committee (Healthfinch)
• Thinking Small: 5 Things I’ve Learned About Writing Health Content for Kids (Healthwise)
• Pivoting Patient Access Strategies: Connecting Patients to Care During COVID-19 (Kyruus)
• Financial Recovery for Health Systems is at Least a Year Away. Going Digital Can Accelerate It (Loyale Healthcare)
• Helping Fund the Future of Healthcare (Netsmart)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 7/1/20

Top News

UCSF pays $1.14 million to ransomware hackers to regain access to servers in its medical school.

BBC gained real-time access to the price negotiations between UCSF and the customer service website (!!) of the hackers, which was used to negotiate the final payment amount.

The UCSF negotiator told the hacker that the university had been financially devastated by COVID-19 and offered $780,000 instead of the demanded $3 million, finally settling on $1.14 million.

Reader Comments

From TheRona: “Re: KLAS. Santa Rosa Consulting and The HCI Group have their scores temporarily suspended pending a ‘data integrity review.’ What’s the scoop?” I reached out to KLAS and received a statement from Adam Gale that I’ll summarize as follows. KLAS found during its routine data checks that an unnamed company was offering to boost vendor KLAS scores for a price via sample manipulation, sometimes falsely claiming to vendors to whom it was pitching that they were working in partnership with KLAS. KLAS says it immediately removed suspicious survey responses and data, also noting that few companies responded to the unnamed company’s offer.

From Buzzword Compliance Department: “Re: telehealth and telemedicine. Interested in the difference. Anyone care to elaborate?” I’ve seen unconvincing arguments that the terms mean different things, and I acknowledge the vast difference between “health” and “medicine” without the prefix, but I think usage has made the terms synonymous. It’s like EMR and EHR – we pretend to support “health” and use that term even though we really just care about the “medicine” part of delivering profitable encounters. I would say that telemedicine specifically refers to physicians practicing medicine from a location that is remote from the patient, while telehealth theoretically could involve other kinds of practitioners or non-professionals who are helping someone with health issues or even activities that don’t involve patients directly. Now let’s move on to “virtual visit” – is that video only, or does a telephone conversation, SMS message, or email exchange count? (I’m voting the latter).

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor RxRevu. The Denver-based company improves healthcare by supporting informed, consistent, and frictionless prescription decisions, partnering with the largest PBMs and payers to bring accurate insurance coverage and cost data into the prescriber’s EHR workflow. The company’s Real-Time Prescription Benefit cost transparency solution brings real-time patient- and pharmacy-specific information, such as cost, coverage restrictions, deductibles, and therapeutic alternatives. Prescription Decision Support promotes condition-appropriate prescribing and cost transparency to improve patient safety and satisfaction while reducing prior authorization work. The company is working with 2,000 health systems that use Epic or Cerner, and in the first five months of 2020, it processed coverage and cost information queries from 110,000 providers in completing 10 million transactions with PBMs. Thanks to RxRevu for supporting HIStalk.

I rarely edit or otherwise alter reader comments, but I’m reminding myself and readers of the significant exception – I don’t allow comments that accuse people by name of doing something illegal or immoral. I’ve edited or deleted a couple this week because it is not fair to allow someone who is anonymous to make unproven accusations about someone who isn’t, although sometimes the political ones fall into that gray area of “public figure” with some health IT relevance and I’ll let them slide.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

People

Fortified Health Security hires Dave Glenn (CBI) to the newly created role of chief revenue officer.

Announcements and Implementations

New Zealand’s MercyAscot private surgical facility goes live with InterSystems TrackCare during the country’s COVID-19 lockdown, using Microsoft Teams and remote training tools to perform a virtual implementation.

Healthcare managed detection and response services vendor CI Security announces integration with Internet of Things and Internet of Medical Things security vendors Ord, Medigate, and Cylera.

AMIA changes its November 14-18 annual meeting to a virtual event.

Government and Politics

DOJ charges Miami entrepreneur Jorge Perez and several co-defendants with fraudulently billing $1.4 billion in healthcare charges from his EmpowerHMS hospitals, netting him $400 million. Jorge Perez bought or took over management of 18 struggling, tiny hospitals and promised to save them by using them to bill out-of-state lab tests at rural hospital rates. One hospital in a town of 1,800 billed $92 million in lab tests in just six months. Insurers got wise and stopped paying for the tests, causing 12 of the hospitals to file bankruptcy and eight to close. Hospital employees reported that their electricity was turned off for non-payment, they were stuck with medical bills due to unpaid insurance premiums, and one hospital had its beds repossessed while patients were in them. One of the defendants is Seth Guterman, MD, who had developed software to maximize rural hospital billing and who is president and founder of Chicago-based EHR vendor Empower Systems.

COVID-19

Anthony Fauci, MD tells the Senate’s HELP committee on Tuesday that he wouldn’t be surprised if the daily number of new COVID-19 infections in the US rises from 40,000 now to an eventual 100,000. He warned Sunday that the US may not reach herd immunity even if a successful vaccine is developed because so many people will probably refuse to take it.

CDC Principal Deputy Director Anne Schuchat, MD says it is no longer possible to bring COVID-19 under control in the US, with the daily record number of new infections making it impossible to control the outbreak with contact tracing and quarantine. She says the experience with coronavirus will be similar to the Spanish flu of 1918 and nothing will stop it until a vaccine is developed. Schuchat was a key CDC player in previous outbreaks of H1N1 and SARS. Meanwhile, HHS Secretary Alex Azar says the” window is closing” to use the only available tools to address COVID-19 – distancing and masks.

Morgan Stanley’s COVID-19 model says epidemic doubling time has worsened to 41 days from 46 days last week, with Texas and Florida likely to have uncontrolled spread within 10 days if they don’t take aggressive action.

Arizona reported 4,700 new cases on Monday, with the largest increase being those aged 20-44 who also make up 22% of hospitalizations. The state has re-closed bars and other businesses, prohibited gatherings of more than 50 people, and pushed back school openings until mid-August. Florida reported 6,000 new cases on Monday with a positive testing rate of 14.4%.

A Harvard-NPR analysis finds that while US testing has improved to about 600,000 per day, it would take 4.3 million tests per day, coupled with contact tracing and a focus on people in high-risk settings, to suppress the infection’s spread.

The EU opens travel to its 27 countries starting Wednesday to residents of 14 nations whose 14-day COVID-19 infection rate per 100,000 people is as good or better than the EU average. Residents of the US will not be traveling to Europe for the foreseeable future.

Texas Medical Center redesigns its ICU capacity report to reflect the ability of its hospitals to use flexible capacity, responding to concerns from Governor Greg Abbott, who said that the previously reported 100% ICU occupancy was unduly alarming people. Projected bed occupancy growth predicts a move to Phase 2 ICU capacity on Wednesday. The total number of admitted patients who tested positive for COVID-19 was stable for weeks at under 500 per day until May 30, when the number started its steep, steady climb to the current 1,500+. The state’s Phase 2 reopening started on May 18.

Researchers find an emergence of a condition they are calling Multisystem Inflammatory Syndrome in children who are hospitalized for COVID-19. Those affected have heart problems, coagulation disorders, and gastrointestinal symptoms.

Former FDA Commissioner Scott Gottlieb, MD says that rapidly increasing case numbers in high-population states like Florida, Texas, and California mean that half of the US population will have had COVID-19 by the end of the year even if the current rate doesn’t increase.

Two Texas friends got tested for COVID-19 at the same facility before spending two weeks camping with others, yielding the same result (negative) but wildly different charges – one who didn’t want to bother using his insurance paid $199 in cash, while his friend is now stuck with a $900 balance that remained from Austin Emergency Center after her insurance company negotiated down the original $6,400 charge. She then went to the local TV station, after which the facility predictably cancelled her balance due.

A Michigan college bar that was allowing patrons to ignore distancing and mask requirements is linked to 107 new cases of COVID-19. Meanwhile, UW Health says that contact tracers are finding that a high percentage of newly infected COVID-19 patients in Epic’s home county of Dane were exposed from large gatherings in bars.

Other

Telehealth visit counts have steadily declined since their mid-April peak, dropping from 14% of all visits to less than 8% as the availability of in-person visits returned. Potential red flags in this finding are: (a) telemedicine visits were counted from scheduling software appointment types, which may not be reliable; and (b) the report counted percentage of total visits as in-person visits were increasing, which provides no insight into the change in the absolute count of telehealth visits.

Sponsor Updates

• Johns Hopkins Medicine will add HCPro’s library of physician query templates to its physician query system from Artifact Health.
• The Chartis Group publishes a new white paper, “Under Attack: Five Practical Steps to Thwart Increased Cyber Threats.”
• Clinical Architecture makes available its presentation from HL7’s FHIR DevDays, “Data Quality in FHIR: Lessons from the Field.”
• Ensocare welcomes Ashley Gorham (Medical Solutions) as an account executive.
• Hyland Healthcare will use MedPower analytics and tools to manage end-user training on its enterprise information platform.
• In Australia, MercyAscot implements TrakCare patient administration and billing software from InterSystems.
• Dimensional Insight will sponsor the St. Jude Walk/Run Boston on September 26.
• Health Data Movers hires recruiters Brett Kimes (Oxford Healthcare IT) and Durc Strand (Pivot Point Consulting).

Blog Posts

• Healthcare Supply Chain: PAR vs. Perpetual Inventory Systems (Impact Advisors)
• How to Prepare for Epic Optimization and Upgrades (314e)
• The Essential Resource Guide to Hospital-Enabled Virtual Care – Part 2 of 5 (Access)
• Simple Efficiency Strategies & Tools that Allow You to See More Patients (AdvancedMD)
• Lessons Learned for Locating Displaced Individuals Following Hurricanes (Audacious Inquiry)
• COVID-19 Financial Recovery Guide: Leveraging Patient Financial Clearance (Bluetree)
• Maximize Top-Line Revenue with Care Automation (Bright.md)
• Creating better healthcare experiences for transgender and gender-nonconforming patients (Nordic)
• Digesting the Data: CMS COVID-19 Nursing Home Numbers (CarePort Health)
• The COVID Factor: What Health System CIOs Are Saying About Their IT Priorities Now (CereCore)
• How to Keep Care – and Hospital Revenue – Going During a Pandemic (Central Logic)
• 3 Indicators to Monitor for Business Email Compromise (BEC) (CI Security)
• COVID-19 and the New Normal for Health Plans (Collective Medical)
• Diameter Health Technology’s Impact on HEDIS Reporting, by the Numbers (Diameter Health)
• The Value of Data in COVID-19 Contact Tracing (Dimensional Insight)
• How Advocare Put Healow TeleVisits to Work (EClinicalWorks)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 6/29/20

Top News

Cybersecurity firm Expanse finds from monitoring the Internet traffic of six unnamed Fortune 500 healthcare companies that:

• Half are getting traffic from exposed Remote Desktop Protocol servers, which allows brute force password guessing.
• One-third are receiving Internet accesses from the deprecated Server Message Block v1 that is used for printer and port access, a popular way to spread major attacks such as Petya and Wannacry.
• One-third showed regular traffic from servers and devices in Iran, opening them to the possibility of state-sponsored attacks in the absence of geographic traffic filtering.
• Every company had outbound Tor traffic originating from its network, indicating that their security policies do not prohibit it.

Some of the RDP servers had brute-force password-guessing attacks underway and did not have Network Level Authentication enabled.

The SMB traffic indicates that those companies were already the victim of data exfiltration.

HIStalk Announcements and Requests

Three-fourths of poll respondents who have had a recent telehealth encounter provided their pre-visit information via an electronic form or upon being asked by someone other than the provider. Some gave their information directly to the clinician, while 12% either weren’t asked about allergies, meds, history, etc. or had to volunteer it.

New poll to your right or here: When will healthcare conference attendance rise to 75% of pre-COVID levels? Your answer will need to incorporate your predictions of the underlying factors, such as availability of an effective COVID-19 vaccine, healthcare business conditions, attending conferences versus alternatives, etc.

I was thinking about the challenge of getting people to wear masks despite their indifference, ignorance, or pathetic choice of ways to protest whatever it is that they’re angry about. My idea – hire marketing people to mount multiple targeted campaigns like the successful “Don’t Mess with Texas” anti-littering one from years ago. We know now that the pandemic isn’t going away soon, so we have time to convene focus groups and think of creative ways to encourage people to put them on given that rational thought isn’t doing it. I suggest distributing free masks that bear the same kind of lowbrow messages that people are willing to deface their cars to display publicly — think stick figure families, cartoons of a Ford truck owner peeing on a Chevy, 13.1 and 26.2 ones (ironically placed on vehicles), or those oval ones with made-up airport codes touting town pride. We know that marketing and social media advertising change behavior in ways that science and empathy won’t.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Microsoft will close all of its physical stores.

People

Predictive EHR workflow vendor Wellsheet hires Frederik Lindberg, MD, PhD (Friend Health) as VP of product management.

Announcements and Implementations

Redox publishes a podcast that describes its recent layoff of 44 employees and how it made the decisions that were required, making the process transparent in hoping to help other companies that are navigating their recovery from the pandemic.

Government and Politics

The White House asks the Supreme Court to overturn the Affordable Care Act, which would eliminate health coverage for 23 million Americans.

COVID-19

Case counts spiked in 36 states over the weekend, with Florida’s nearly 10,000 new cases on Saturday rivalling New York’s worst historic levels. More than 40,000 new cases were reported nationally on Friday as the CDC reports that actual numbers are likely six to 24 times higher. The US death count is at 127,000 as experts question whether the economic pain that was inflicted during the months-long but effective national shutdown was worth it now that complacence has raised the “flatten the curve” imperative once again.

Texas Medical Center stops publishing its base and surge ICU numbers, right after Houston area hospitals walked back their “our ICUs are about to be overwhelmed” message just 18 hours later in saying that they have plenty of capacity and their earlier dire warnings were overly alarming. This came days after the governor ordered hospitals in four Texas counties to stop performing profitable elective surgeries. Some Harris County hospitals are ignoring the governor’s order and the Texas Hospital Association says individual hospitals should be able to decide for themselves whether to perform elective procedures. The state has 5,500 patients hospitalized with COVID-19, extending its 16-day string of ever-increasing inpatient counts. TMC just announced that it will bring back the missing information in a form that better explains the capacity situation.

Texas reports hours-long lines for COVID-19 testing, along with limited capacity due to a shortage of supplies and crashing of websites for testing sign-up.

In Australia, the government’s $2 million COVID-19 contact tracing app has been downloaded 6 million times, but has yet to identify any contacts that hadn’t already been found via manual tracing. The app seems to have problem when the IPhone of the user or their contact is locked. Problems have also been noted with IPhones and Android phones sharing information. Of 926 new cases, only 40 people had the app installed and allowed health officials to look at the contacts it had flagged.

Former FDA Commissioner Scott Gottlieb, MD predicts that schools won’t open in the South in the fall due to the overwhelming infection spread. He also notes that the US was doing a poor job of contact tracing even before the daily new infection count hit 40,000, where such activity becomes basically impossible anyway.

A New York Times report says that college towns will be hit hard economically from COVID-19 due to reduced on-campus living, cancelled sporting events, and closed bars, calling out specifically campuses in rural areas such as those of Cornell, Amherst, and Penn State.

Arizona — which still hasn’t closed bars, mandated the wearing of masks, or prohibited large indoor political rallies without masks — publishes a point system to decide who gets ICU resources versus those who will be left to die without them. Arizona has 2,700 patients hospitalized with known or suspected COVID-19 (triple the number from a month ago) and nearly 500 are on ventilators (double the month-ago count). Nearly 90% of adult ICU beds are occupied. Imagine how bad it would be if the mostly elderly snowbirds in Arizona and Florida weren’t gone for cooler weather elsewhere.

New York State reported just five COVID-19 deaths on Saturday versus its previous peaks of around 800. The state mandates a 14-day quarantine for visitors from high-infection states.

Harvard’s Ashish Jha, MD, MPH raises the interesting point that while young patients have lower COVID-19 mortality rates than older ones, it is true of every disease that younger people have better survival odds. He looks at it differently: a 40-year-old patient who is admitted for COVID-19 has the same mortality rate as a 70-year-old who has a heart attack. Coronavirus still kills 5% of hospitalized patients aged 35-44 and Florida’s numbers are skewing much worse.

Members of the Congressional Hispanic Caucus demand that HHS explain its HHS Protect COVID-19 data project, for which it issued a $25 million contract with Palantir, whose data products are used by ICE to find and arrest immigrants. HHS says the HHS Protect information is de-identified. The CIA is an investor in the company.

UCSF’s Bob Wachter, MD summarizes the present state nicely.

Sponsor Updates

• PMD VP of Business Development Ted Ranney, MBA publishes a Medical Economics article titled “Telehealth best practices: Building a long-term workflow.”
• Nuance announces that its AI Marketplace for Diagnostic Imaging is accelerating AI adoption for radiologists at leading healthcare systems.
• OmniSys and RedSail Technology announce a strategic partnership to bring innovative clinical and revenue cycle solutions to independent and long-term care pharmacy markets.
• IDC recognizes Pure Storage as a top five vendor in the OEM storage space.
• Redox releases a new podcast, “Layoffs.”
• Saykara launches a YouTube channel.
• Summit Healthcare publishes a new case study, “Surgery Partners: Improving Processes with RPA Across all Meditech Platforms; Magic, 5.x, 6.x, and Expanse.”
• Researchers publish “Factors Associated with Prescribing Oral Disease Modifying Agents in Multiple Sclerosis: A Real-World Analysis of Electronic Medical Records” based on data from TriNetX’s network.

Blog Posts

• A Real View: Radiology’s Post-COVID Road to Recovery (Nuance)
• Are You Ready for the Busiest Immunization Season Ever? (OmniSys)
• How Real-World Evidence is Shaping the Response to COVID-19 (Premier)
• Building Remote Cultures Before, During and After Zoom Pandas (SailPoint)
• Your gauge for patient education (StayWell)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 6/26/20

Top News

Kaufman Hall spins off its enterprise performance management software division as Syntellis Performance Solutions, with investment from private equity firms Thoma Bravo and Madison Dearborn Partners.

Kaufman Hall’s Kermit Randa will move to the new company as CEO.

The business was created from Kaufman Hall’s Axiom Software and its recently acquired Connected Analytics practice of Change Healthcare.

Reader Comments

From Barely Covered Enmity: “Re: Shafiq Rab leaving Rush University Medical Center. Interesting that his LinkedIn says he is a senior advisor to Michael Dandorph, the CEO of Wellforce. Bill Shickolovich is still listed as CIO, but Dandorph came from Rush. Wellforce is a relatively new player in MA, with Tufts Medical Center primarily on Siemens, Lowell General on Cerner, and Melrose-Wakefield on Meditech. Most affiliated providers are on eCW. They have announced plans to move all to Epic.”

From Generally Specific, MD: “Re: telemedicine EHR entries. Our billers tell us that we have to record three numeric entries in the vital sign section of our EHR to quality for telemedicine payment. You’re allowed to take the patient’s word on height and weight (yup). Some people will give you a temp, home blood pressure check, or data from Apple Watch or Fitbit. When all else fails, I see if they can feel a pulse (big one in neck if wrist fails) and have them count while I time 15 seconds on my phone. Or watch them breathe. If someone doesn’t look good, I have to get them seen in person anyway.”

From Swag Seeker: “Re: conferences. Will HLTH cancel?” They already have. HLTH announced last week that the October event will be virtual (meaning: a flop.) HLTH has held just two conferences in its short existence, the first in May 2018. I would not want to be HIMSS, RSNA, or other non-profits that fill the bank mostly from their member conferences, but HLTH is even worse off in being funded by VCs and having no other line of business to fall back on. HLTH made some puzzling decisions about locations and dates early on but managed to lure a lot of healthcare luminaries and their expense accounted-fueled groupies to generally positive reception. They will now try again in Boston in October 2021, assuming that (a) they survive, and (b) that anyone cares by then. Conferences aren’t coming back strong until a year or two after a vaccine is proven to be effective, if ever, and we may have found better ways to spend the time and money of our employers by then.

HIStalk Announcements and Requests

I’m watching and recommending  the Netflix medical documentary series “Lenox Hill,” which follows four doctors and their patients at Northwell Health’s Lenox Hill Hospital. Fun fact: Northwell pays featured neurosurgeons David Langer, MD (above) and John Boockvar, MD more than $2 million each per year. Google-stalking suggests that Langer’s summer house in the Hamptons, site of the retreat the doctors attended, is worth a cool $3 million. Still, they seem like highly competent, mostly nice guys, although I bet that being surgeons that some critical, loudly recited monologues to eyes-downcast co-workers were left on the virtual cutting room floor.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

The Massachusetts EHealth Collaborative will sell its remaining assets and shut down operations. The non-profit sold its technology assets and customer accounts to population health management and analytics vendor Arcadia last month. The majority of its employees, including President and CEO Micky Tripathi, have joined Arcadia.

Sales

• Idaho will integrate its PDMP data into statewide EHR and pharmacy systems using Appriss Health’s PMP Gateway solution.
• Teleradiology company Rapid Radiology selects OpenText’s EMR-Link software to ensure smoother transfer of imaging results to providers at long term care and skilled nursing facilities.
• The University of Illinois Hospital and Health Sciences System will implement PhysIQ’s PinpointIQ remote patient monitoring technology to monitor employees for signs of COVID-19, and high-risk COVID-19 patients for signs of deterioration.
• Wexford PHO goes live on the all-payer population health management solution of SPH Analytics.
• Fairfield Medical Center (OH) chooses Updox for patient flow management, in-office productivity, and virtual care.
• The DoD gives Leidos a $170 million task order for MHS Genesis services that will include program management, enterprise sustainment, license maintenance, and operational management services.
• Texas Health Aetna will use the SMS/IVR technology of CareSignal for remotely monitoring patients with diabetes, hypertension, and asthma.

People

Cambridge Health Alliance names Hannah Galvin, MD (Beth Israel Lahey Health) as CMIO.

Shannon Werb (Virtual Radiologic) joins DispatchHealth as COO.

The HCI Group names Will Conaway (Prime Healthcare) VP of provider delivery.

Announcements and Implementations

The Froedtert & the Medical College of Wisconsin rolls out a remote patient monitoring program for pregnant patients using technology from Babyscripts made available through digital health prescription vendor Xealth, which includes the health system among its investors.

PatientPing launches an e-notification service for patient admissions, discharges, and transfers that ensures providers are compliant with the Condition of Participation laid out in the final Interoperability and Patient Access rule from CMS.

Nordic develops an evaluation and management transition service to help health systems comply with CMS’s E/M updates, set to take effect January 1.

UCI Health (CA) adds Everbridge’s MediNav wayfinding technology to its My UCI Health app.

MuleSoft announces GA of Accelerator for Healthcare, a set of prebuilt APIs, integration templates, and best practices that can help developers more easily integrate data from different EHRs into healthcare projects. Salesforce acquired the company in 2018 for $6.5 billion.

Mayo Clinic (MN) launches a home healthcare service using technology from Medically Home. The service falls under the health system’s relatively new Mayo Clinic Platform, an initiative led by John Halamka, MD that aims to create new ventures using the latest technologies.

Healthcare voice AI vendor Suki launches a new voice service that it says will deliver faster, more accurate company responses from normal physician speech. Its digital clinical assistant has also been enhanced with ICD-10 coding, Epic integration, and delivery of an app for Android smartphone users.

COVID-19

Texas Governor Greg Abbott bans elective surgeries in Bexar, Dallas, Harris, and Travis counties to free up bed space for the state’s rapidly expanding epidemic. Texas Medical Center says it will need to tap surge capacity this week and is on track to exceed total capacity within two weeks. The governor will also halt further reopening phases, acknowledging the state’s “massive outbreak” after it rushed to reopen despite increasing numbers. Abbott said two weeks ago that there was no reason to worry about reopening because “we have so many hospital beds available to anybody who gets ill.” Texas allows churches, governments, daycare centers, and camps to operate without occupancy limits, while bars, sporting events, swimming pools, libraries, and amusement parks can operate at 50% occupancy. Restaurants are limited to 75% capacity. Abbott, who previously refused to require mask-wearing and barred local officials from implementing their own mask requirements, encouraged Texans to wear masks in announcing his executive order Thursday. Perhaps it bears repeating that being discharged alive from a COVID-19 hospital stay doesn’t preclude a shortened lifetime of suffering, never-ending medical interventions, and hugely diminished quality of life. The ability to get an ICU bed and ventilator should not provide a false sense of security.

Public health officials in Austin, TX blame COVID-19 case counts that vary wildly by day on labs that are sending test results by fax, requiring their employees to re-enter the information manually. County officials want to know which labs are involved for possible enforcement of the state law that requires digital reporting.

COVID-overwhelmed Arizona is experiencing the same problems that other states ran into early in the pandemic — long lines for testing, a shortage of testing capacity, and a lack of coordination among hospitals and doctors offices to match testing demand to availability.

West Virginia Governor Jim Justice fires Cathy Slemp, MD, MPH, commissioner of the state’s Bureau of Public Health, claiming that her office unintentionally inflated COVID-19 case counts by failing to exclude recovered patients.

CVS Health announces GA of Return Ready, a customizable COVID-19 screening, testing, and analytics program for employers and universities that also offers digital tools for symptom monitoring and contact tracing.

Bars are increasingly looking like a COVID-19 breeding ground in states where they are open, with factors being close quarters, fearless young customers who don’t wear masks, proprietors who flout distancing and crowd size mandates, and loud conversations that spray more droplets. Patrons who don’t know they’ve been infected are spreading the infection to people who are more cautious.

COVID-19 is forcing health system to change their plans for developing hotels to house elective surgery patients and visitors, many of them cash-paying residents of other countries. Miami’s $500 million, 680-foot tall Legacy Hotel and Residence will feature a 256-room hotel, a 100,000 square foot medical center, condos, bars, restaurants and shops, but its CEO says he doesn’t use the term “hospital” for reasons that go beyond the legal one of not offering emergency services — “You’re in a luxury hotel. You don’t want to be around people who are dying.”

Other

The American Hospital Association loses its bid to stop the federal government from requiring hospitals and insurers to publish their negotiated prices. AHA had argued that the White House did not have the legal authority to require such disclosure, that compliance would create overwhelming administrative burdens, and that such transparency might increase prices. The federal judge disagreed, ruling that informed customers should drive prices down and that hospitals attack transparency measures in general to keep patients in the dark about pricing. Hospitals are appealing the ruling.

A review of the VA’s HIT-related outpatient diagnostic delays over several years finds five key high-risk areas: overwhelming EHR inbox notifications and communications and lack of coverage for absences; lack of interoperability and visible surfacing of important information; technical problems; data entry issues; and systems that don’t track test results. It cites previous studies in which PCPs reported missing abnormal test results because of an overloaded EHR inbox that requires more than an hour per day to work through. Specific cases were interesting:

• Physicians who were notified by note to correct an EHR entry sometimes signed off without actually making the correction.
• One clinician missed an abnormal test result that was among the 200 inbox notifications they received in one day.
• Results were sent to clinicians who were on leave or who had left the organization with no one assigned to cover their inbox.
• Use of note templates sometimes caused the recipient to miss important information.
• Clinicians missed information due to delays in obtaining records, missing fax reports, delays in outside organizations posting diagnostic information to record-sharing portals, and failure to notify the clinician to review records that had been scanned.
• Clinicians sometimes failed to review abnormal test results in subsequent encounters.
• One clinician had customized the EHR to display only abnormal results, but missed one abnormal result because an abnormal cutoff value had not been defined.
• Inactive radiology codes failed to trigger notification.
• Abnormal result warnings were set to disappear when opened, so clinicians lost track if they were interrupted.

Sponsor Updates

• VMblog features an interview with Goliath Technologies CMO Stacy Leidwinger.
• Google Cloud hires Kathy Bonanno (Palo Alto Networks) as finance lead.
• Halo Health publishes a case study, “Schedule-Driven Communication Improves Collaboration for Great River Health System.”
• Pivot Point Consulting expands its telehealth services to offer end-to-end solutions, from strategy to platform selection to implementation.
• Hyland CEO Bill Priemer shares his thoughts on potential challenges and the unknowns around working from home.
• The Boston Globe features Imprivata CEO Gus Malezis in an article assessing COVID-19’s impact on office work.
• Seeking Alpha profiles digital prescription savings and patient engagement company OptimizeRx.
• Vocera partners with Mediaplanet to launch the “Empowering Our Healthcare Heroes & First Responders” media campaign.
• PMD successfully completes its annual SOC 2 Type II and HIPAA security audits.

Blog Posts

• The Essential Resource Guide to Hospital-Enabled Virtual Care / Part 2 of 5 (Access)
• Cyberattacks: Don’t Overlook Medical Devices (Capsule)
• Overview of Nordic’s Upgrades and Ticket Backlog Solution (Nordic)
• Cross-State Nurse Licensing: One Way to Improve Care During COVID-19 (Health Catalyst)
• Clinical NLP Part 3: Streamlining, Optimizing Medical Necessity Review (Wolters Kluwer Health Language)
• Tracking Renewal Request Volumes to Optimize Staffing (Healthfinch)
• Bridging the Social Determinants of Health Gap Between Payers and Providers (Imat Solutions)
• IT Assessment: Am I Organized for Success in the Long Run? (Impact Advisors)
• Everyone wants to work remotely … now what? (Infor)
• Pivoting Patient Access Strategies: Connecting Patients to Care During COVID-19 (Kyruus)
• Providing feedback to HIT vendors: Five strategies that work (Intelligent Medical Objects)
• Five Critical Operational and Financial Capabilities Required for Healthcare’s Financial Survival (Loyale Healthcare)
• The Pros and Cons of Hiring Contract Physical Therapists (MWTherapy)
• Best Practices: Building a Long-Term Telehealth Workflow (PMD)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 6/24/20

Top News

CMS Administrator Seema Verma says that analysis of Medicare claims confirms that socioeconomic status, race, and ethnicity of COVID-19 patients affect their likelihood of complications.

Verma says the US health system needs to transition from fee-for-service to value-based care and to hold providers accountable for outcomes.

CMS has started publishing a monthly Medicare COVID-19 Data Snapshot. The initial release indicates that 325,000 Medicare beneficiaries were diagnosed with COVID-19 through May 16, with 110,000 of them being hospitalized. Blacks were hospitalized at a rate four times that of whites.

CMS also announces the creation of CMS’s Office of Burden Reduction and Health Informatics, which will look at the burden of meeting CMS compliance requirements, fostering innovation through interoperability, and using technology to create new tools to allow patients to own and carry their health data and to give clinicians their complete medical history.

Reader Comments

From Wilson’s Gremlin: “Re: telehealth visits. I’m wondering what percentage have deficient pre-screenings performed (temperature, blood pressure) because appointments are remote? Or that require patients to leave home afterward for follow-up (for blood to be drawn or for a nasal swab)?” Good question – maybe someone knows. That would lead me to wonder whether traditional practices had to reconfigure their EHR to make in-person measurements such as temperature optional rather than required. It would also be interesting to know how many physical trips a virtual visit generates (lab, pharmacy, X-ray, PCP, etc.) although most of those would have been required even with a face-to-face visit.

HIStalk Announcements and Requests

Newbie vendor prospecting and marketing people are working energetically from home with minimal supervision and mentorship, so I’ll provide these tips:

• Do not “circle back” if a health IT executive didn’t find your first unsolicited email interesting enough to respond the first time.
• Do not hound people on LinkedIn with unsolicited connections and boilerplate messages.
• Do not send unsolicited calendar appointments.
• Whatever your company sells may well be the most important part of your universe, but the provider world is dealing with decimated revenue and COVID-19 challenges, so you aren’t anyone’s top priority.
• Those books on lead generation, sales funnels, and social media marketing that you ordered from Amazon push ideas that are not only ineffective in selling to the health system C-suite, but often detrimental.
• Focus on their problems, not your needs.
• It is risky for an industry newbie to pursue a conversation with someone who has decades of health IT leadership. Your unfamiliarity with the industry’s lingo, lack of broad knowledge, and insecurity-driven adherence to the company-approved conversational script makes success unlikely even if you get someone on the phone.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Cerner conducts another round of layoffs, this time involving 100 employees. The nails-on-blackboard corporate phrase “new operating model” was uttered yet again as an explanation.

CoverMyMeds finds in a comprehensive prescription access report that 70% of patients have made sacrifices to obtain their medications, while 30% of providers say their patients are unable to pay for meds. COVID-19 has caused changes – 20% of patients paid cash for prescriptions; two-thirds say they are more likely to use telehealth going forward; 30% of providers say their biggest telehealth challenges are privacy concerns and lack of EHR integration; and 80% of providers say their telemedicine use is hampered by patients who lack technology skills. Patients who are prescribed specialty medications report delays of up to several weeks waiting for prior authorization. Most prescribers don’t trust the formulary and insurance benefit information contained in their EHRs and 86% of them say their office bears a “high” or “extremely high” workload burden in managing prior authorization requests.

High-acuity house call provider DispatchHealth raises $136 million in a Series C funding round, increasing its total to $217 million. It offers home visits that can include lab work, EKG, infectious disease tests, medications, IV placement, breathing treatments, suturing, catheter placement, and splinting.  The company operates in 19 cities and accepts many insurances, leaving patients an out-of-pocket cost that averages $5 to $44.

Sales

• Billings Clinic (MT) will implement TransformativeMed’s specialty- and disease-specific EHR workflows, which include notification, messaging, and a COVID-19 app. The company will also be developing a nursing handoff app.

People

Physician practice change analytics vendor Empiric Health hires Spiro Papadopoulos (Stanson Health) as VP of business development.

Shally Pannikode (WellStar Health System) joins Humana as CVP/CIO of healthcare services.

Rush University Medical Center SVP/CIO Shafiq Rab has resigned, according to his LinkedIn.

Announcements and Implementations

AbleTo launches population-based virtual mental health services to payers.

PatientKeeper develops its Charge Capture software into a FHIR-based app that is embedded in Cerner, allowing clinicians to launch the charge entry screen within their Cerner workflow to record patient charges.

COVID-19

US COVID-19 infection doubling time has dropped from 60 days last week to 52 days now, with 31 states reporting an expanding epidemic. Deaths are at their lowest levels in three months, however, leading to interesting speculation as to why. Most likely answer – younger people are getting increasingly infected without becoming seriously ill, but the infection’s spread to more vulnerable populations in the absence of mitigation strategies is inevitable. Most optimistic but unlikely answer – treatments and care management are improving outcomes.

Coronavirus seems to be infecting people under 50 at higher rates than were observed in the Northeast, with 50% of hospitalized patients and 30% of those in ICUs being under 50 in the Dallas-Fort Worth area. The median age of people who are testing positive in Florida has dropped from 65 years in March to 35 now, which may be a function of more widespread testing, but also possibly because older people are protecting themselves better. Florida hospitals are admitting more COVID-19 patients in their 20s, 30s, and 40s.

Texas Children’s Hospital starts admitting adult patients to free up Houston-area beds for the expected surge of COVID-19 patients. Houston Methodist Hospital says COVID-19 admissions have tripled since Memorial Day.

A preliminary report suggests that oral dexamethasone – which is cheap, readily available, and low in significant side effects — can reduce mortality in hospitalized COVID-19 patients, especially those who are ventilated or receiving oxygen.

The European Union is likely to add the US to its list of countries whose citizens will be barred from entering its 27 countries because of out-of-control COVID-19 spread. Travel restrictions will be loosened on July 1 for countries whose new infections in the previous 14 days meet or beat the EU’s average of 16 per 100,000 residents. The US is at 107.

A COVID-19 congressional hearing finds that President Trump hasn’t spoken to the government’s key pandemic players in several weeks, including NIAID Director Anthony Fauci, MD and FDA Commissioner Stephen Hahn, MD. CDC Director Robert Redfield, MD declined to answer when asked.

Other

A White House executive order suspends issuance of H-1B work visas through at least the rest of the year, prohibits US companies from transferring foreign executives to long-term US assignments, and blocks US entry of spouses of foreign-born workers. The federal government says the order will keep 525,000 people out of the country to protect American jobs. The H-1B employer program is for highly educated people in specialty occupations, most of them in technology, medicine, academics, and engineering.

Cerner VP of Government Services Julie Stoner says the VA’s rollout will take 10 years.

Sponsor Updates

• Pivot Point Consulting performs a virtual Epic go-live at Carle Foundation Hospital (IL).
• Central Logic CEO Angie Franks will describe health system telehealth use cases in a presentation this week to the virtual American Telemedicine Association Conference & Expo.
• Health Catalyst joins the FDA’s COVID-19 Evidence Accelerator.
• Optimum Healthcare IT and University of North Florida create an EHR apprenticeship program called Last Mile Training.
• Capita Healthcare Decisions adds Healthwise’s evidence-based information to its Salus Universal patient engagement and relationship software.
• The Chartis Group publishes a new white paper, “After the Surge: Five Health System Imperatives in the Age of COVID-19.”
• Clinical Computer Systems, developer of the Obix Perinatal Data System, releases the latest edition of its Critical Care Obstetrics Podcast, “DKA Made Simple.”

Blog Posts

• 3 Aspects of Epic Interfaces Worth Outsourcing (314e)
• Improve staff-manager relationships with collaborative scheduling (Ability Network)
• 3 Ways You’re Wasting Time in Your Medical Practice (AdvancedMD)
• Nurses of Spok: Kiley Black on blending technology and nursing (Spok)
• Agfa HealthCare shortlisted at the new Health Tech Leaders Awards 2020 (Agfa Healthcare)
• Supporting Epic Clinical Users During Staffing Mobilization (CereCore)
• Why It’s Critical to Choose an ONC-Certified EHR Solution (ChartLogic)
• The Increasingly Critical Role of Home Health (Collective Medical)
• Removing Barriers to Patient Care at the Pharmacy (CoverMyMeds)
• What Are the New CMS and ONC Interoperability Rules for Payers? (Cumberland Consulting Group)
• Using TCM to Improve Care & Capture Revenue (EClinicalWorks)
• Using NEMT to Solve for COVID-Related Obstacles (Ensocare)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 6/22/20

Top News

In Russia, President Vladimir Putin calls for the healthcare system there to roll out out digital systems and to use artificial intelligence.

Putin told health workers in a videoconference that Russia should use its experience in successfully addressing coronavirus to improve the overall reliability of its healthcare system.

Reader Comments

From Options Exercise Program: “Re: PatientPing’s delayed funding announcement. If you’re going to disclose a raise, make it timely. When public companies do this, we (the investor research community) used to call it ‘painting the tape.’ It matters because the backdrop between now and then is very different. Raising the money during this current time (COVID) sends a very different signal of optimism than it did when the raise occurred. Same quarter plus or minus is fine, but not 16 months.”

HIStalk Announcements and Requests

More than half of poll respondents expect the use of virtual provider visits to increase in the next year over today’s already-increased levels, although two commenters correctly observed that the challenges are not related to technology limitations, consumer or provider preference, or clinical outcomes – it’s all about payments by CMS and insurers.

New poll to your right or here: For those who have had a recent telehealth visit: how was pre-visit information (allergies, meds, recent history, current problem, etc.) collected?

Listening: new from Travis, a Scotland-based (“Glaswegian,” a new word to me) indie band that has been around for 30 years. They couldn’t make a video for the new tune because of coronavirus lockdowns, so singer Fran Healy and his son drew their own.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

People

Arcadia promotes Debbie Conboy to VP of risk adjustment and quality products and hires Catherine Turbett, MHA (Lumeris) as VP of ACO and health plan account operations.

Announcements and Implementations

KLAS didn’t send me its “US Hospital EMR Market Share 2020” report, so I’ll summarize what its blog post says. Only Epic and Meditech had a net gain in hospitals in 2019. Epic has won most of the new big-hospital decisions over several years, but Cerner bagged the DoD/VA elephant. KLAS says there is room for another market entrant, but it glosses over the time, money, and determination that would be required to develop, sell, and install a new hospital EHR. On an unrelated note, I have a minor grammatical quibble with KLAS for writing “multi-tenet” instead of “multi-tenant.”

COVID-19

The New York Times reports that nursing homes are taking advantage of being off limits to ombudsmen during the pandemic by evicting low-profit residents — such as those on Medicaid — to free up beds for profitable COVID-19 patients. Some facilities have discharged residents with no notice to unregulated boardinghouses and cheap motels, sometimes without notifying their families. Nursing homes make much of their profit from post-surgery rehab patients who are covered by private insurance, the supply of which has dwindled as hospitals halted non-essential services. Seventy percent of US nursing homes are for-profit businesses, with 11% of them being owned by private equity firms.

Former FDA Commissioner Scott Gottlieb, MD says that the 10 states that are seeing record-high new COVID-19 cases (AL, AZ, CA, FL, NV, NC, OK, OR, SC, TX) are losing control of the epidemic, as doubling time has fallen to under 10 days. He questions whether the governments of those states possess the political will to implement mitigation steps that could slow the spread. Researchers have noted that states that have higher mobility and low testing and tracing are more likely to be experiencing outbreaks. Arizona’s positive test rate is at 17% and its case count has turned sharply upward, far more than any other state. Thoughts that COVID-19 will throttle itself back in the heat – which were already questionable given its early impact in warm areas of the globe – should consider Arizona (highs in Phoenix are at 110 degrees) as evidence to the contrary, or perhaps more specifically, that congregating indoors under air conditioning without masks once lockdowns have eased is great viral exploit.

President Trump tells attendees of his Tulsa rally that he ordered government officials to slow down COVID-19 testing. He explained, “When you do testing to that extent, you’re going to find more people. You’re going to find more cases. So I said to my people, slow the testing down, please.”

The American Red Cross says blood donations have dropped sharply due to lockdowns and coronavirus fears, and as an incentive to lure donors back, is offering them a free COVID-19 antibody test.

A Harvard working paper finds that the COVID-19 mortality rate of black people ranges from seven to nine times higher than that of white people, depending on age group, meaning that the “years of potential life lost” of both blacks and Hispanic / Latino populations are higher than that of whites despite their much smaller population. 

ProPublica reports that 12% of New Jersey’s nursing home residents died of COVID-19, along with 6% of all nursing home residents in New York, when the states ordered unprepared nursing homes to take all hospital transfers and prohibited them from testing prospective residents for COVID-19 in a “reverse triage” attempt to free up hospital beds. State officials based their order on federal guidance that allowed such transfers if the nursing home met a list of criteria, but nobody was sure who was responsible for assessing their readiness. A Wall Street Journal investigation found that 50,000 of the country’s 122,000 COVID-19 deaths have involved long-term care residents and employees.

Former FDA Commissioner Robert Califf, MD says that while the US is applying impressive technology expertise to COVID-19, we’re ignoring the basics, such as wearing masks and distancing.

Other

A federal grand jury indicts a Detroit man for the 2014 hack of UPMC’s HR system, where he is accused of selling the information of 65,000 employees on the dark web to conspirators who used it to file fraudulent tax returns. The LinkedIn of Justin Sean Johnson says he is a Oracle PeopleSoft expert who worked as a a self-employed cybersecurity researcher for several years, now employed as an IT specialist at FEMA.

Sponsor Updates

• Premier develops Intersectta, an oncology-focused group purchasing organization to source cancer and other specialty drugs.
• Relatient publishes a new case study, “Cherokee Health Systems Powers Telehealth with Patient Engagement, Goes Live Across 24 Locations During COVID-19.”
• CareSignal publishes a case study titled “How Mercy Built a Technology-Enhanced Care Management Model to Scale Care Management and Increase Patient Engagement.”
• Saykara congratulates customer OrthoIndy on receiving the Healthgrades 2020 Patient Safety Excellence Award.
• Spok appoints Brett Shockley (Journey.AI) to its board.
• TriNetX will partner with Parexel to advance real-world data use in clinical development.

Blog Posts

• IT Assessment: Am I Organized for Success in the Long Run? (Impact Advisors)
• PMD: Helping Practices and Patients Navigate Telehealth When They Need it Most (PMD)
• Getting Back to Regulatory Readiness (Premier)
• How to Put Your RPA in 6th Gear (Summit Healthcare)
• Leading a Data-Driven Healthcare Marketing Culture (SymphonyRM)
• Year of the Nurse and Midwife 2020 – What’s Your Story? (Vocera)
• More than PPE: Safety Precautions for Physical Therapists in the Age of COVID-19 (WebPT)

Sponsor Spotlight

Get-to-Market Health is a specialized consultancy focused exclusively on accelerating sales and driving revenue growth for healthcare solution providers. We work with business leaders to simplify the complexity and unique buying patterns of the healthcare market. Bringing deep, broad experience and valuable network connections, the partners at Get-to-Market Health are industry experts. We have worked at and with dozens of healthcare technology businesses ranging from small startups to large, established companies. We help our clients navigate the challenges they face as they work to drive revenue and market innovation.

(Sponsor Spotlight is free for HIStalk Platinum sponsors).

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 6/19/20

Top News

Member-owned health plan Health Care Service Corporation will create a Payer Platform to connect its health plans to in-network Epic-using health systems for reviewing patient data, managing claims payment and prior authorization, and facilitating care management.

HCSC is the country’s fifth-largest health insurer, with 16 million members enrolled in Blue Cross Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas.

HCSC acquired care management solutions vendor Medecision for $121 million in mid-2008 and is a partial owner of clearinghouse operator Availity.

Reader Comments

From Cellular Terrorist: “Re: COVID-19. You should call out the states that refused to apply sound public health measures and are now having record-breaking case numbers.” The problem with the federal government allowing states to do whatever they want is that we as a country can’t or won’t curtail unencumbered travel, so a Florida resident or visitor who parties down mask-free could spread COVID to more responsible areas in the “weakest link” theory. COVID-19 has demonstrated that we Americans don’t care much about science and can’t be bothered with inconveniences like wearing masks unless they promise to save us instead of someone else, so perhaps the “we’re all going to get it eventually anyway” crowd is right. What happens in Vegas doesn’t unfortunately stay in Vegas when it comes to coronavirus.

From Contact Tracy: “Re: contact tracing. See this press release for what my company is about to launch.” As an occasional bearer of bad news, allow me to level-set you: (a) use of any contact tracing app in the US will be under 15% and will drop quickly, making zero difference, and what little adoption there is will be all Apple and Google; and (b) contact tracing in general in the US won’t work because nobody trusts anybody, especially anyone connected with government in any form, enough to give them any personal information, much less their contact names and information, and they won’t even answer phone calls and emails from public health officials. We had better excel at developing a vaccine since every prevention strategy that worked elsewhere — lockdowns, masks, widespread testing, contact tracing, travel limitations, and immunity passports – requires nearly universal adoption and won’t fly in a fatally divided country like ours. Not to mention that we are a lot unhealthier than much of the developed world and will experience a higher rate of coronavirus-related deaths as result. We’re at 120,000 now, more than two Vietnam Wars’ worth (and to paraphrase Chief Brody said in “Jaws,” you’re gonna need a bigger wall). 

HIStalk Announcements and Requests

The grocery chain pharmacy (those are always cheaper than drugstore chains in my experience) filled my 360-day prescriptions for blood pressure and cholesterol meds with a 91-day supply even though I wanted a full year’s worth and was paying cash using a GoodRx coupon. They said GoodRx rejected the 360-day quantity, so I called GoodRx and was quickly connected to a pleasant, actual human who verified that some vaguely described policy limits fills to a 91-day supply in some cases. She could not describe those cases or explain why the app would issue a coupon that was not valid. I still got a year’s supply, paying $82 instead of the expected $60, and only then because the pharmacist found a coupon from a GoodRx competitor. At least the recent federal change that prohibits PBMs gagging pharmacists from telling patients about lower-cost options worked for me and I was impressed with GoodRx’s customer service. Meanwhile, CNBC reports that the software guys who started GoodRx have built a business worth $3 billion in finding yet another illogical loophole in our illogical healthcare non-system.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

PatientPing confirms the reader rumor that I recently ran: the $60 million Series C fund raise that it announced last week was actually completed in February 2019. The company told me that it held the announcement “to peg it to exciting company milestones and product capability rollouts,” which was explained to the Boston business paper as waiting on CMS to publish legislation that requires hospitals and EDs to send ADT notifications, a core capability of PatientPing. That CMS action was delayed, so the announcement was held as well. Experts note that private companies like PatientPing can announcing funding whenever they want or can skip an announcement altogether. It doesn’t feel right to me to hold off for 16 months, but only because a prospect might infer overly optimistic business conditions during a pandemic in which health systems have been nearly shut down for months.

Redox confirms a reader-reported rumor I sent their way, acknowledging that it laid off 44 people, about 25% of its headcount, on Tuesday. The company says it had planned to double its size in 2020 as it had in 2019 and hired accordingly, but COVID-19 changed the focus of financially strapped health systems. Redox is working with customers and partners to place those of its employees who were affected  –contact christine@redoxengine.com.

Social services referral software vendor Unite Us acquires Staple Health, an analytics company that focuses on social determinants of health.

Signify Research reviews the plan of Mednax to sell its radiology groups and Virtual Radiologic teleradiology business, with the company renaming itself back to its original name of Pediatrix Medical Group as a pediatrics and obstetrics business. Signify notes that the company paid $500 million for VRad in 2015, added 10 practices, and grew revenues by 10% to $3.5 billion, but piled on debt and saw EBITDA slide 24% over the four years. VRad is the world’s largest teleradiology provider. The company announced in early April that it would cut executive salaries, furlough and reduce the pay of non-clinical employees, and cut non-essential expenses in reaction to COVID-19. Signify expects VRad to benefit from its work on AI algorithms over the past several years.

Sales

• MultiCare Connected Care (WA) selects Innovaccer’s Data Activation Platform and InGraph population health analytics.
• Stonewall Memorial Hospital District (TX) selects CPSI’s Evident EHR and TruBridge RCM software and services.
• AdventHealth will implement Virtustream’s Healthcare Cloud to power its new Epic system.

People

Craig Joseph, MD (Avaap) joins Nordic as chief medical officer.

Arcadia promotes Debbie Conboy to VP of risk adjustment and quality products and hires Catherine Turbett (Steward Health Care) as VP of ACO and health plan account operations.

Announcements and Implementations

OrthoIndy (IN) implements Saykara’s AI-based physician charting app.

COVID-19

NIH’s All Of Us research project adds three COVID-19 data collection components for researchers who are approved to study data from its 350,000 participants:

• Testing at least 10,000 samples from recent enrollees for COVID-19 antibodies, hoping to determine rates of exposure by region.
• An online survey that asks about COVID-19 symptoms, stress, social distancing, and economic impact that participants can take monthly to understand effects over time.
• EHR data analysis from the 200,000 participants who have shared their information, with plans to standardize the information to investigate patterns, symptoms, associated health problems, and the outcome of drugs and other treatments.

Scientific American explains the accuracy rates of COVID-19 antibody tests, which are particularly important since the results are often considered reliable without verification. The authors explain that false-positive results, which are the most impactful, are more likely with low infection rates. Example: the same test that has 95% specificity (few false positives) and 95% sensitivity (few false negatives) will give a false-positive rate of 14% when the infection rate is 25%, but will issue falsely positive results 50% of the time when the infection is 5%. In other words, COVID-19 antibody tests are likely to issue a lot of false positive results that may encourage people to return to normal life because they think they are immune (not to even mention that nobody has proven that people who have COVID-19 antibodies are immune from reinfection).

FDA will participate in the COVID-19 Diagnostics Evidence Accelerator, a real-time diagnostic testing evaluation program that is a companion to the previously announced Therapeutic Evidence Accelerator.

The Equal Employment Opportunity Commission says that employers can’t require employees to take COVID-19 antibody tests before returning to work, basing its decision on CDC’s warning that antibodies don’t equate to immunity and therefore testing for them should not drive workplace decisions.

Other

It’s not just COVID-related fears that are keeping people away from medical practices and hospitals – the New York Times reminds readers that millions of Americans have lost jobs, income, and health insurance during the pandemic and can’t afford the high cost of healthcare, especially after reading about the aggressive debt collection practices of hospitals and practices. I’ll add one more item – even those who are able to get new health insurance will see their deductibles reset, meaning that someone with an ACA plan could be looking at several thousand dollars of deductibles before insurance starts paying anything.

Epic employees will return to the company’s headquarters in Verona, WI in four stages during July and August. Over one-third of the company’s employees have already returned to office work. The company says it is slowly resuming essential travel.

Researchers note that patient race and ethnicity are often used by algorithms that drive clinical decisions even though nobody knows whether underlying genetics are causing the observed differences in outcomes. The researchers caution that it’s not wise to simply apply a race-based digital fudge factor without knowing if genetic differences are responsible rather than societal issues, economic factors, or past inequities. Otherwise, minority patients may be denied services because of misinterpreted risk factors or the assumption of suboptimal outcomes.

Sponsor Updates

• RamSoft adds QliqSoft’s virtual visit technology to its RIS/PACS solutions.
• Healthwise receives five Digital Health Awards during the Health Information Resource Center’s 2020 spring competition.
• Intelligent Medical Objects publishes a new white paper, “The Evolution of the EHR.”
• Medhost joins the Amazon Web Services Partner Network as a Technology Partner.
• Black Book ranks Netsmart #1 in 10 categories across behavioral health and post-acute settings, including top overall post-acute care IT services and solution vendor.
• BridgeHealth offers its members access to flexible physical therapy solutions through WebPT’s Networks program.
• MDLive CMO Cynthia Zelis, MD joins the NCQA’s Taskforce on Telehealth Policy.

Blog Posts

• First CGM Basal-Bolus Insulin Titration Study Shows Future Potential for Remote Patient Monitoring (Glytec)
• Data scientists assist medical researchers in the fight against COVID-19 (Google Cloud)
• Finding the telehealth-life balance (Greenway Health)
• HealthNxt: The Next Great Advance in Virtual Care (The HCI Group)
• The Right Skills at the Right Time for Healthcare IT (HCTec)
• Activity-Based Costing in Healthcare During COVID-19: Meeting Four Critical Needs (Health Catalyst)
• I am still a nurse: Supporting the clinical voice of our customers (Hyland)
• Role of Health Data Analytics in Post COVID-19 World (Imat Solutions)
• Use Your COVID-19 Work to Build Data Governance (Impact Advisors)
• How to avoid disruption from loss of technical expertise (Infor)
• An Unprecedented Challenge: Serving Our Customers Through Passion and Commitment (InterSystems)
• CFO Playbook – Turning Financial Trauma into Transformation (Loyale Healthcare)
• Key Tips to Address Technology Frustration Within Your Organization (Netsmart)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 6/17/20

Top News

Epic cancels its UGM 2020 user meeting, which was scheduled for August 24-27 in Verona, WI.

Epic says some UGM elements will be offered online even though “we truly believe that an in-person meeting is irreplaceable.”

A CIO reader says the CEO council and CIO roundtable will still be offered, although they add, “Not sure who is attending either one given travel budget cuts.”

Reader Comments

From Newly Jobless: “Re: [company name omitted.] Laid off 25% of staff today.” Unverified. I didn’t get this in time to confirm with the company before my Tuesday evening deadline and I saw nothing on TheLayoff.com, but if you were affected, let me know.

From Prudent Investor: “Re: your readership stats. How now compared to last year?” Up, and I’m surprised to be getting more inquiries from potential sponsors than back in the heady days of Meaningful Use. I guess the lost conference year of 2020 left companies with more marketing money but fewer channels for exposure. Investment activity seems robust as well, so I suspect companies are eyeing the opportunity to gain competitive advantage in a suddenly leveled playing field.

From Hopeful Employee: “Re: Revint. I’ve been here two years and they just announced the third CEO since I started. I hope this one fires the management team and invests to integrate all these companies that New Mountain Capital has thrown together. They weren’t even honest about firing the current CEO, we employees aren’t idiots.” Scroll down to the People section for the new CEO’s details.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Halo Health. The Cincinnati-based, physician-founded company offers the Halo Clinical Communication and Collaboration Platform (CCCP), a scalable, AWS cloud-based solution that includes secure messaging, on-call, role-based scheduling, VoIP calling, critical results, alerts, and care team tools in a unified mobile platform. The Halo Platform’s unique workflow management system instantly delivers time-sensitive information to the right person, role, or team, allowing health systems to accelerate patient care, increase clinician efficiency, and improve financial outcomes. Halo is a strategic technical and clinical workflow partner dedicated to achieving customer objectives such as standardizing communication, consolidating technology, and connecting the physician community. Thanks to Halo Health for supporting HIStalk.

Webinars

June 18 (Thursday) 12:30 ET. “Understanding the ONC’s Final Rule: Using FHIR HL7 for Successful EHR Integrations.” Sponsor: Newfire Global Partners. Presenters: Bob Salitsky, healthcare IT expert, Newfire Global Partners; Jaya Plmanabhan, MS, healthcare data scientist. This fast-paced, 30-minute webinar will provide an overview of the Final Rule and describe how technology vendors, payers, and providers can use FHIR HL7 to deliver true interoperability. Attendees will learn how to define the data, technology, and flows needed for their EHR integration projects; how products can retrieve health information while meeting compliance regulations; and the benefit of adopting quickly to the future of data exchange while simplifying future integration efforts.

Acquisitions, Funding, Business, and Stock

Proteus Digital Health, the “smart pill” digital health darling that was once valued at $1.5 billion, files Chapter 11 bankruptcy. The company staked its future on the support of drug manufacturers, who are known for deep pockets but a short attention span for shiny technology objects.

Walmart acquires the technology assets of online pharmacy CareZone for a rumored $200 million. The company’s app allows consumers to scan their pill bottles to create a medication profile, set up reminders, and track health measurements. CareZone will continue to operate its pharmacy, which was excluded from the network of pharmacy benefits manager Express Scripts a couple of years ago in a contract dispute.

Abacus Insights, which combines EHR and third-party data to allow health plans to personalize the care experience of their members, raises $35 million in a Series B funding round.

CareMesh – whose communications platform includes a national provider directory, event notifications, secure communications, and care transition workflows – raises $5 million in a seed funding round.

Surgisphere, the tiny company whose questionably sourced aggregated EHR data was responsible for two major research article retractions, takes down its website and social media accounts. I noticed that founder Sapan Desai, MD, PhD has also removed his LinkedIn. Some speculate that the company has shut down, which would be reasonable given the permanent stench that is now attached to its name.

People

Geeta Nayyar, MD, MBA (Greenway Health) joins Salesforce as executive medical director.

Revenue integrity technology vendor Revint hires Lee Rivas (RELX) as CEO.

Announcements and Implementations

Experity launches Face Sheet, a patient history view of its urgent care EHR that provides an overview of past visits, supporting urgent care “hybrid clinics” that are providing primary care services or other continuing services.

Inspira Health (NJ) goes live on KyruusOne and ProviderMatch for Consumers, both from Kyruus.

COVID-19 testing company Curative is using the interoperability platform of Redox to send results to state health departments.

Epic highlights the use of its Pulse Central, which aggregates data from 1,200 Epic-using hospitals, to send standard COVID-19 metrics to public health organizations in near real time.

Carequality publishes an implementation guide for electronic case reporting, which can be used to report infectious disease cases to public health organizations.

Access releases Impression, a new version of its paperless, web-based electronic forms solution that allows hospitals to send patients forms (such as for pre-registration) for electronic completion and signing from anywhere. 

The American College of Cardiology will offer its members Heartbeat Health’s digital platform for cardiology-specific telemedicine and virtual care, which incorporates doctor-patient sharing of wearables-powered diagnostics, remote patient monitoring, and outcomes tracking. I interviewed Heartbeat Health founder and CEO Jeff Wessler, MD, MPH a few months back and I confess that it’s one of my favorites – he was refreshingly thoughtful about his vision of how cardiology practice can be optimized with a combination of in-office visits and virtual care that emphasizes prevention as well as treatment.

COVID-19

FDA revokes its emergency use authorization of hydroxychloroquine and chloroquine for treating COVID-19, finding that the drugs don’t have enough potential benefit to outweigh their risk of side effects that are sometimes fatal. HHS Secretary Alex Azar says that the only impact of the decision is that hospitals can no longer use federal stockpiles of the drugs — doctors can still prescribe them however they want and the FDA change may clear up misunderstanding that they are for hospitalized patients only.

Researchers question whether the medical journal peer review process is broken following retraction of articles by NEJM and The Lancet whose flaws that were obvious to expert readers. Issues:

• Peer review isn’t intended to detect outright fraud, which may or may not be involved in the retracted articles that used data from Surgisphere.
• COVID-19 has created an urgency to get information to the front lines within days rather than the usual many months, leaving little time for review.
• The supply of unpaid, uncredited, well-credentialed peer reviewers is limited.
• NEJM says it should have used hospital data experts in its peer review and pledges to require independent validation of database quality going forward.

The New Yorker describes how some Utah startups with little healthcare knowledge threw together COVID-19 tools (testing, online assessments, and a command center) to rush into a no-bid contract with the state in public-private partnership called TestUtah that was expanded to other states. The reliability of TestUtah’s results came into quick question; it was using tests that had not been allowed in the US until an FDA emergency use authorization was issued; its testing machine was approved only for use on agricultural DNA rather than human RNA; and it was stockpiling hydroxychloroquine in planning to offer treatment as well as diagnosis. TestUtah processed its lab tests in an unmarked back room of a 122-bed hospital that had equipment stacked on old desks and conference room tables sitting on carpeted floors, using a home food sealing machine to seal specimens. CMS inspectors noted several problems with its process and threatened to sanction the hospital’s lab for failing to supervise its work. TestUtah blames the criticism it received on political partisanship and the desire of University of Utah’s lab company and Intermountain Healthcare to squelch competition. The state overrode the recommendations of its public health director to extend TestUtah’s contract, then demoted her.

A tiny lab in Texas is billing insurance companies several thousand dollars for a COVID-19 test that costs just $100 from the major labs, taking advantage of a mandate from Congress that requires insurers to pay the full costs of the tests for out-of-network lab work.

FDA gives emergency use authorization for US hospitals to use an AI-powered COVID-19 patient deterioration early warning tool that was developed by Israel-based tele-ICU platform vendor CLEW. 

Other

A study finds that the rate and completeness of public health disease reporting by hospitals, practices, and labs improves when using HIE-generated, pre-populated forms instead of filling out and faxing paper forms.

Sponsor Updates

• Pivot Point Consulting will offer health-risk trajectory analytics from Jvion to help hospitals get employees back to work and patients back to their normal care activities.
• A proof-of-concept study finds that patients who used Glytec’s Glucommander insulin dosing software with a continuous glucose monitoring system showed a 26% improvement in time in range.
• AdvancedMD releases a new e-book, “Post-COVID-19: Moving to ‘Better Than Normal’ – four essential elements in getting past merely normal.”
• Microsoft features Central Logic in its special COVID-19 podcast series.
• Clinical Computer Systems, developer of the Obix Perinatal Data System, releases a new episode of its Critical Care Obstetrics Podcast, “Simulation Mistakes.”
• Black Book ranks Nordic as #1 in client satisfaction in the category of strategic initiatives advisory.

Blog Posts

• 3 Reasons You Need Professional Healthcare IT Testing for Interoperability (314e)
• Three tips for a better nurse engagement that drives quality care (Ability Network)
• The Essential Resource Guide to Hospital-Enabled Virtual care: Part 1 of 5 (Access)
• 5 Reasons Why Health Systems Need to Implement an Enterprise Imaging Platform (Agfa Healthcare)
• The Case for a Situational Awareness Network for Emergency Response (Audacious Inquiry)
• Health Plan Learnings from Our COVID-19 Efforts (CarePort Health)
• Legacy Data Archive: Avoiding the Sticker Shock of Data Retention (CereCore)
• ChartLogic Lands Among SoftwareAdvice’s EHR FrontRunners (ChartLogic)
• Navigating new Medicare hospital outpatient department authorization requirements (Nordic)
• Be Ready for a Breach: The Case for Remote DFIR and Virtual Incident Response (CI Security)
• 10 Steps to Ensure ERP Health (Optimum Healthcare IT)
• Meeting the Needs of Complex Patient Populations Through Care Collaboration (Collective Medical)
• Electronic Prescription Management and Enrollment for Specialty Medications (CoverMyMeds)
• The Future of Healthcare: How Telehealth Will Change After COVID-19 (Dimensional Insight)
• BAYADA: Proactive COVID Safety Plan Helps Client Acquisition, Staff Retention (Dina)
• Finding a New Normal: The Patient Experience (EClinicalWorks)
• 7 must haves for your patient scheduling system (Experian Health)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 6/15/20

Top News

Milliman acquires Wisconsin-based employee health monitoring technology vendor Healthio, which it will pair with its predictive analytics offering.

Reader Comments

From Lab Matters: “Re: article titles. I see some that capitalize just the first letter of the first word, while others capitalize each word. Am I stuck in the grammar rules of the past? Please help settle my existential conflict.” I capitalize each word because a title looks like a weird sentence to me otherwise. Not to mention that the style guides of AP, APA, Chicago, MLA, and New York Times all agree that the first, last, and important words of an article’s title should be capitalized. However, a recent AP change suggests using “sentence style” for headlines and websites, where only the first word and any proper nouns are capitalized in a “Hawaiian shirt Friday” kind of formally dictated informality. This would be one of a few cases in which I disagree with AP since it seems to be bowing to those who didn’t know or didn’t follow its longstanding rules, although I acknowledge that sentence case is probably a bit easier to read as long as it is used consistently within the same website. I resolve my existential conflicts on style by carefully thinking through the options, choosing the one that makes most sense to me, and sticking with it, and in the spirit of grammatical harmony in the title capitalization question, I use the original style rather than my own when I cite an article from elsewhere. Let’s not even acknowledge that some health IT vendor website capitalize all letters in their press release and blog titles, maybe the same ones that insist on capitalizing all the letters in the company’s name (which gets put right back to first-letter-only here per AP style).

HIStalk Announcements and Requests

Folks who work in health IT are nearly evenly split over whether they would trust research findings based on aggregated EHR information.

New poll to your right or here: How will the use of virtual provider visits change between now and June 2021?

Welcome to new HIStalk Platinum Sponsor Saykara.The Seattle-based company is working to combat the epidemic of physician burnout that has surfaced from increasingly burdensome documentation requirements and time spent on EHR data entry. They’ve built the first fully ambient and autonomous AI-powered assistant for physicians. Their iPhone app, named Kara, listens to physician-patient conversations, then interprets and transforms the salient content required for notes, orders, referrals, and more, and enters both structured and unstructured data directly to the EHR. Kara is specialty agnostic and being used by doctors all across the country. Data shows that time spent charting is reduced by an average of 70%, after-hours (“pajama time”) charting is eliminated, and note quality and completeness is enhanced by 25%. Saykara was founded in 2015 by Harjinder Sandhu, a serial healthcare technology entrepreneur and former Nuance executive who has stood at the forefront of innovations in speech recognition and machine learning for more than 20 years. See their video featuring doctors from Hancock Health. Thanks to Saykara for supporting HIStalk.

Webinars

June 18 (Thursday) 12:30 ET. “Understanding the ONC’s Final Rule: Using FHIR HL7 for Successful EHR Integrations.” Sponsor: Newfire Global Partners. Presenters: Bob Salitsky, healthcare IT expert, Newfire Global Partners; Jaya Plmanabhan, MS, healthcare data scientist. This fast-paced, 30-minute webinar will provide an overview of the Final Rule and describe how technology vendors, payers, and providers can use FHIR HL7 to deliver true interoperability. Attendees will learn how to define the data, technology, and flows needed for their EHR integration projects; how products can retrieve health information while meeting compliance regulations; and the benefit of adopting quickly to the future of data exchange while simplifying future integration efforts.

Acquisitions, Funding, Business, and Stock

The investment firm owner of Clinical Ink is putting the drug clinical trials electronic tools company on the market after owning it for two years.

A false claims act whistleblower lawsuit brought against EHR vendor Medhost and Community Health Systems by two former CHS IT executives is dismissed, with the judge saying that the “heaps of alleged facts” that were presented don’t prove the claimed misconduct.

Sales

• United Methodist Communities (NJ) will implement systems from VirtuSense and Netsmart as funded by a grant from the FCC’s COVID-19 Telehealth Program.
• MetroHealth (OH) will use the social services referral platform of Unite Us. Co-founder and CEO Dan Brillman, MBA is a US Air Force Reserve major and pilot with campaigns in Iraq and Afghanistan, while co-founder Taylor Justice, MBA graduated from West Point and served as a US Army infantry officer.

People

Digital ambulatory surgery platform vendor ValueHealth hires Don Bisbee, MBA (Cerner) as president.

COVID-19

One-fifth of US nursing homes have less than a week’s supply of PPE on hand despite the federal government’s April 30 promise to help them with their needs to address COVID-19, which has killed 43,000 residents. Many have not received PPE shipments, some received only cloth masks and low-quality ponchos, and most say the quantities they received will last only a few days. The head of one Catholic nursing home group concludes, “The federal government’s failure to nationalize the supply chain and take control of it contributed to the deaths in nursing homes.”

A Seattle man who recovered from COVID-19 after a 62-day hospital experiences survivor’s guilt after seeing his hospital bill of $1.1 million, which doesn’t include the two-week rehab stay that followed. Medicare will cover most of his bill and he may pay nothing because of the federal government’s COVID-19’s bailout money, which the Seattle paper says is “like we’re doing an experiment for what universal health coverage might be like, but confining it to only this one illness.”

Rates of new cases and test positivity are trending up in Arizona, California, Florida,and Texas, suggesting that hospitalization and ICU bed usage will be increasing to possibly dangerously high levels over the new few weeks.

A new study of COVID-19 in Japan finds that symptom-free people aged 20-39 were most often the source of primary exposure, while healthcare facilities were most often involved. The authors also conclude that close-proximity singing, cheering, exercising, and bar conversation were associated with many of the clusters.

Other

Former Mass General Brigham and Cerner executive John Glaser, PhD makes the case to redesign EHRs around the patient-clinician medical plan rather than their current role as a place to record the byproducts it generates. He advocates keeping existing EHRs while addressing specific needs via wrap-around modules that providers can buy to meet their specific challenges (population health management, HIEs, patient-facing apps, and analytics). The next-generation EHR should include:

• A library of situation-specific care plans.
• Treatment algorithms.
• A master plan that is supplemented with to-do lists for each type of caregiver.
• Interoperability that allows the plan to travel across care settings, geographies, and EHRs.
• Decision support and workflow.
• Analytics tools that assess the patient’s individual plan and apply relevant lessons learned from the broader patient population.

County-owned, 647-bed New Hanover Regional Medical Center (NC) entertains acquisition and partnership offers from the state’s big health systems, with Duke Health offering $1.35 billion, Novant committing to $1.5 billion at closing and $2.5 billion in improvements, and Atrium Health offering a 40-year lease at $28 million per year and along with $2.2 billion in improvements.

Epic sends an internal email only to its diversity, equity, and inclusion employee groups, warning them that they should not participate in a virtual walkout in support of Black Lives Matter. Some white employees complained to the local paper that the email should have gone to everyone.The company also updated its employee policy to limit use of company resources for work purposes.

In Canada, the medical association of Newfoundland and Labrador complains about the government’s new app that connects people with a nurse practitioner in an extension of its 811 HealthLine telephone program. The doctors are unhappy that they weren’t consulted and are worried that the NP won’t see the patient’s electronic record, but the health minister says that’s a problem in general because some doctors use paper charts, some use an EHR, and some use Meditech’s regional implementation. He adds that the service was launched because people are happy with their virtual visits with doctors and they are equally effective as face-to-face visits in most cases, also noting that doctors don’t have a monopoly on providing healthcare services.

Sponsor Updates

• ChartLogic is named as a SoftwareAdvice.com’s EHR FrontRunner.
• PatientKeeper wins a Bronze PR Club Bell Ringer Award for its integrated marketing communications strategy.
• The local paper profiles PerfectServe’s efforts to provide providers with free software and services during the pandemic.
• The Big Unlock podcast features Phynd CEO Tom White.
• Redox releases a new podcast, “Powered by Battery with Redox CEO Luke Bonney.”
• Summit Healthcare names Amanda Mehlenbacher (Nicholas H. Noyes Memorial Hospital) implementation engineer.

Blog Posts

• How health systems can optimize revenues and resources (Ingenious Med)
• AI in Healthcare: 3 Tips to Avoid Common Pitfalls (Pivot Point Consulting)
• The Not-so-New Normal (PMD)
• Meeting Unparalleled Demand for Critical Supplies and Drugs (Premier)
• Explore the Pure//Accelerate “Un-keynote” Keynotes (Pure Storage)
• Virtual Patient Waiting Rooms: What They Are, Why You Need One, and How to Create It (Relatient)
• In Favor of the Shift (SailPoint)
• Classifying Data Processing (Spirion)
• Checking Up on Content, to Check in with Patients (StayWell)
• Right Around the Corner: 2021 CMS Rule Requiring Real Time Benefit Tools (Surescripts)
• End-of-Life Visitation with Safety and Compassion (Vocera)
• Everything You Need to Know About Legally Providing Telehealth (WebPT)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 6/12/20

Top News

Silicon Valley investment firm Iconiq makes a “significant” investment in healthcare workforce management software vendor QGenda that values the company at just over $1 billion.

Francisco Partners, which considered selling the company in May, will remain Atlanta-based QGenda’s majority owner.

Reader Comments

From Going Live: “Re: EHR go-lives. Are they still happening? What measures are being taken to protect those involved?” The only go-lives I’ve heard about in the past couple of months were done remotely, but perhaps others have been involved in the traditional version and can report. I would be surprised if hospitals that were preparing for COVID overrun and banning patient visitors were simultaneously undertaking a go-live that involved on-site help.

From Confused: “Re: [vendor name omitted.] Announced new funding, but this news is 16 months old, according to former employees.” I reached out to the company, which says it held the announcement “to peg it to exciting company milestones and product capability rollouts.” I’m not listing their name since this could be commonly accepted practice for all I know and there’s no reason to call them out if so. I didn’t find any of the usual investment sources that listed the actual funding date — they all used the recent announcement date instead. Maybe the biggest takeaway here is that while it is impressive that companies are announcing new funding during a pandemic and its associated economic downturn, the funding itself may have occurred before all that happened or when its competitive situation was different than now.

From Doctor Doctor: “Re: COVID-19. I’ve seen a lot of dumb opinions and advice from doctors quoted on news sites and social media.” As have I. People erroneously think that all doctors from every practice setting are science-based, apolitical, free of commerce-related bias, current in their knowledge, and just as qualified as epidemiologists, virologists, and public health experts to speak authoritatively on COVID-19’s transmission, mitigation strategies, and treatment.

HIStalk Announcements and Requests

Somehow I missed that John Glaser left Cerner back in November 2019, according to his LinkedIn. He’s on the board of health IT-related organizations Press Ganey, EHealth Initiative, InTouch Health, American Telemedicine Association, PatientPing, Relatient, and Scottsdale Institute, also serving as a senior advisor to Brighton Park Capital.

Webinars

June 18 (Thursday) 12:30 ET. “Understanding the ONC’s Final Rule: Using FHIR HL7 for Successful EHR Integrations.” Sponsor: Newfire Global Partners. Presenters: Bob Salitsky, healthcare IT expert, Newfire Global Partners; Jaya Plmanabhan, MS, healthcare data scientist. This fast-paced, 30-minute webinar will provide an overview of the Final Rule and describe how technology vendors, payers, and providers can use FHIR HL7 to deliver true interoperability. Attendees will learn how to define the data, technology, and flows needed for their EHR integration projects; how products can retrieve health information while meeting compliance regulations; and the benefit of adopting quickly to the future of data exchange while simplifying future integration efforts.

Acquisitions, Funding, Business, and Stock

Provider search and scheduling software vendor Kyruus raises $30 million in a venture round from Francisco Partners, bringing its total funding to $155 million.

Wellsheet raises $3.8 million in a Series A funding round. The New Jersey-based startup has developed software that uses predictive analytics to optimize provider workflows.

Genetic clinical decision support company ActX secures a patent pertaining to cloud-based storage and real-time distribution of biological information.

Automated virtual care vendor Conversa Health raises $12 million in a Series B funding round.

Sales

• Health and Social Care Northern Ireland signs a $351 million contract with Epic for implementation across five trusts and its ambulance service.

People

Optum promotes former Center for Medicare and Medicaid Innovation director Patrick Conway, MD to CEO of its Care Solutions group.

Virtual care technology vendor Conversa Health promotes Murray Brozinsky to CEO.

Kevin Lynch (Netgain) joins Datica as CEO. Co-founder and former CEO Jeremy Pierotti takes on the role of president.

Announcements and Implementations

Goliath Technologies helps Maimonides Medical Center (NY) anticipate, troubleshoot, and resolve Citrix slowdown issues.

Nuance Dragon Medical One voice assistant users can now access UpToDate clinical content from Wolters Kluwer Health.

Novant Health (NC) implements iQueue for Operating Rooms from LeanTaas to help its surgical facilities ramp back up to pre-COVID-19 capacities.

Health Catalyst will launch a quality reporting product that combines its Data Operating System with measures, visualizations, and workflows from Able Health, which it acquired earlier this year.

Government and Politics

The VA gives Cerner a $99 million task order for sustainment support of hardware and software associated with its $10 billion EHR modernization project.

COVID-19

Regeneron begins the first clinical trials of antibodies for COVID-19 treatment, which if successful, could be cleared for emergency use by fall assuming production can be ramped up.

Researchers identify 12 malware-distributing Android apps that were disguised to look like COVID-19 contact tracing apps issued by the governments of Brazil, Italy, Russia, Singapore, and other countries.

Business Insider reports that just three states – Alabama, North Dakota, and South Carolina – will use contact tracing apps from Apple and Google. Seventeen states have said they won’t use contact-tracing apps at all, while 19 remain undecided.

None of the 140 customers of a Missouri hair salon whose hair was cut by two stylists who worked for eight days despite having active, symptomatic COVID-19 infection have become infected. Health department officials credit the salon’s insistence on mask-wearing by both customers and employees, its wider spacing of chairs, and its staggered appointment times to reduce group waiting. The stylists have been released from isolation. Experts are increasingly convinced that wearing masks could significantly reduce the spread of COVID-19.

Mount Sinai (NY) uses a grant from Microsoft’s AI for Health program to develop an informatics center dedicated to COVID-19 research.

The Department of Justice charges the president of a biotechnology company with submitting $69 million in fraudulent COVID-19 and allergy testing claims to mislead investors. Arrayit’s Mark Schena, PhD allegedly paid kickbacks to doctors for ordering allergy testing regardless of medical need, used the revenue to misrepresent the company’s prospects to investors, then jumped on the COVID-19 bandwagon with diagnostic tests whose accuracy was questionable.

Privacy and Security

StayWell secures the portal it hosts for the State of Kentucky’s health and wellness incentive program after discovering two data breaches that exposed employee email addresses, passwords, and biometric screening and health assessment data. The breach also resulted in fraudulent gift card redemptions.

Other

Bloomberg Businessweek describes the negative effects of private equity firms buying dermatology practices, 10% of which are now owned by PE firms:

• The PE formula of drastically cutting costs and flipping the business for a profit in 3-5 years with a 20-30% annualized return makes it difficult to serve both patients and investors effectively.
• Corporate-owned medical practices are illegal in many states, but lawyers get around that by creating a management company that buys a practice’s non-clinical accesses and bills its doctors for its services, which is supposed to keep medical decisions separate from profit-seeking ones even though PE firms admit that they insert themselves into the clinical side of the practice.
• Doctors in solo practice can sell out for $7-12 million, with some of that paid in equity. Patients are not notified of the practice’s new owner.
• Some of the acquiring firms pay cash bonuses to offices that hit daily and monthly financial goals, encouraging them to perform as many procedures as possible. In some cases, medical assistants earned their bonuses by falsifying documentation and doctors were told to falsely claim that they were supervising PAs.
• PE firms push dermatologists to perform more high-profit procedures such as cosmetic surgery, laser treatments, and Mohs surgeries, the latter of which are sometimes performed by traveling labs that are flown in or that work from temporary parking lot clinics.
• PE firms buy labs and hire their own pathologists to keep revenue in-house, which is legally allowed under Stark laws only for dermatology and a few other specialties.
• Doctors are pushed to see more patients and sometimes are forced to use inferior medical supplies and equipment. One dermatologist says their employer insisted that surgery patients be sent home with open wounds so they would be forced to return the next day for suturing, which allowed the practice to bill them a second time.
• 25% of the dermatologists with the highest biopsy rate work for private equity-backed groups who encourage diagnosing “Pre- pre- pre-cancer” to get patients to have skin blotches removed.
• A dermatologist says that the debt-saddled chains are struggling to find their expected buyers since “there’s a limit to how much money you can make when you’re sticking knives into human skin for profit.” As a result, the PE firms are moving into specialties that perform more invasive procedures, such as urology.

Sponsor Updates

• Banner Health (AZ) expands its use of Spok’s Care Connect communication software.
• Health Catalyst will partner with life sciences company Sprim to use real-world evidence to inform clinical trials for liver disease.
• Gartner includes Imat Solutions in its “US Healthcare Payer CIOs Boost Medicare Advantage Star Ratings Using Engagement Hubs and Insights” report.
• The “HIT Like a Girl” podcast will feature Intelligent Medical Objects CEO Ann Barnes on June 10.
• NextGate’s identity-matching EMPI solution is now available in the Microsoft Azure Marketplace.
• Arcadia makes available a COVID-19 Recovery Toolkit to help its customers resume normal operations.
• Wolters Kluwer Health helps to develop and virtually host the American Diabetes Association’s 80th Scientific Sessions June
• Providers from five health systems will present their experience with implementing Glytec’s EGlycemic Management System during the 2020 Diabetes Technology Society Virtual Hospital Poster Session. 12-16.
• PCare adds on-demand movies and television shows from Tubi to its COVID-19 Tablet Configuration Solution.
• Optimum Healthcare IT posts a case study titled “ Virtual Epic Go-Live at Valley Children’s Healthcare.”

Blog Posts

• 5 ways to enhance your cloud storage security and data protection (Google Cloud)
• Tackle your billing backlog to increase cash flow (Greenway Health)
• What is Clinical Communication? (Halo Health)
• Enabling Digital Foundations for the Future (The HCI Group)
• Clinical NLP Part 2: A Better Equation for Calculating Quality Measures (Wolters Kluwer Health Language)
• Why It’s Necessary to Integrate Protocols into Existing Workflows (Healthfinch)
• The Secret to Creating the Most Satisfied Patients (Healthwise)
• The Essential Resource Guide to Hospital-Enabled Virtual Care | Part 1 of 5 (Access)
• Overview of Nordic’s Capacity Simulation and Management Solution (Nordic)
• 2020 health IT trends: Revisited (Hyland)
• A Leading Look at Revenue Integrity (Impact Advisors)
• Are you getting the most from your IT investments? (Imprivata)
• Creating an effective remote workforce strategy (Infor)
• Help simplify nurses’ lives: 5 ways to streamline nursing workflows (Spok)
• MIPS Registry and Reporting: Increase Quality Time with Patients While Maximizing Revenue (Ingenious Med)
• Moving Toward Meaningful Mental Health Data (InterSystems)
• Meeting Your Communities’ Mental Health Needs During and After COVID-19 (Kyruus)
• How COVID-19 is Advancing Healthcare’s Need for a Digital Transformation (Medhost)
• Strategies to Bolster Infection Control and Surveillance Amid COVID-19 (Netsmart)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 6/10/20

Top News

PatientPing raises $60 million in a Series C funding round, increasing its total to more than $100 million.

Reader Comments

From X-Treem Geek: “Re: Duke–UNC anti-trust lawsuit brought by physicians. Looks like they will soon face a new lawsuit for faculty.” Duke University and University of North Carolina paid $54.5 million in mid-2019 to settle a class action lawsuit in which academic physicians found evidence of a decades-long “no poach” agreement in which the schools agreed to avoid recruiting each other’s doctors to keep salaries in check. The new case seeks damages for non-medical faculty members who were not part of the original lawsuit.

HIStalk Announcements and Requests

Cerner tells me that tiny analytics vendor Surgisphere – which is under fire for its use of EHR data of unknown provenance to publish error-filled, now-retracted COVID-19 research studies – is not a Health Facts customer. Surgisphere has declined to disclose how it obtained a massive database of de-identified patient encounters from hospital EHRs, and many large health systems say they’ve never provided such data to the company. Meanwhile a non-profit in Africa that was using a Surgisphere-provided COVID-19 Severity Scoring Tool powered by the same database rescinds its recommendation of the software.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

Webinars

June 10 (Wednesday) 1 ET. “COVID-19: preparing your OR for elective surgeries.” Sponsor: Intelligent Medical Objects. Presenters: Janice Kelly, MS, RN, president, AORN Syntegrity Inc.; David Bocanegra, RN, nurse informaticist, IMO. The presenters will cover the steps and guidelines that are needed for hospitals to resume performing elective surgeries and how healthcare information technology can optimize efficiencies and financial outcomes for the return of the OR.

June 18 (Thursday) 12:30 ET. “Understanding the ONC’s Final Rule: Using FHIR HL7 for Successful EHR Integrations.” Sponsor: Newfire Global Partners. Presenters: Bob Salitsky, healthcare IT expert, Newfire Global Partners; Jaya Plmanabhan, MS, healthcare data scientist. This fast-paced, 30-minute webinar will provide an overview of the Final Rule and describe how technology vendors, payers, and providers can use FHIR HL7 to deliver true interoperability. Attendees will learn how to define the data, technology, and flows needed for their EHR integration projects; how products can retrieve health information while meeting compliance regulations; and the benefit of adopting quickly to the future of data exchange while simplifying future integration efforts.

Acquisitions, Funding, Business, and Stock

Business Insider profiles Doxy.me, which saw the user count for its browser-based telehealth platform jump from 80,000 in January to 700,000 now. The company is run from the house of the CEO, Medical University of South Carolina Assistant Professor Brandon Welch, MS, PhD, whose doctorate is in biomedical informatics. Headcount has increased from 15 full-time employees to more than 50. The company says it isn’t interested in the pitches it is suddenly getting from venture capital firms that have until now characterized telehealth platforms as a commodity. Welch, who says the company’s main competitor is Zoom, concludes, “The only thing providers care about is a way to connect with their patients. They don’t need all the other crap that other telemedicine solutions are providing. We just keep it simple and made it easy to sign up.” Doxy.me’s basic product is free, with paid upgrades available for expanded functionality and institutional use.

Banyan Medical Systems offers its virtual care and telemedicine platform with no upfront costs to eligible hospitals that are waiting for funding from FCC’s COVID-19 Telehealth Program. I did a double take at the company’s information page that says funding expires on June 31, 2020, a day that will live in infamy for not actually existing.

Sales

• Poplar Bluff Regional Medical Center (MO) will implement Pulsara’s telehealth and communication platform.
• Rady Children’s Hospital – San Diego chooses Syft’s Synergy for supply chain management.
• FDA will use HealthVerity’s privacy-protected data exchange for performing COVID-19 research on real-world datasets.
• North Carolina’s HHS will use a COVID-19 version of the OpenBeds Critical Resource Tracker to track treatment and equipment resources across the state. The existing OpenBeds platform was developed to allow states to pool their behavioral health resources. OpenBeds is owned by Appriss Health, which is best known for its state prescription drug monitoring program systems.

People

Mount Sinai Health System (NY) promotes Kristin Myers, MPH to EVP/CIO and dean for IT.

Announcements and Implementations

A Black Book survey finds that 93% of hospitals and large physician practices have seen financial IT system shortcomings exposed during the pandemic. Most CFOs say they will not reduce or defer financial system spending as they look to IT to improve revenue capture and to provide analytics and forecasting support.

Nemours Children’s Health System (FL) saw its telehealth visit count jump from 800 in April 2019 to 30,000 in April 2020, where it uses InterSystems technology to exchange information between its EHR and the its CareConnect virtual system for scheduling appointments.

OptimizeRx says that a partnership with an unnamed organization will expand the reach of its specialty medication platform to 300 health systems that use Cerner and Epic.

Government and Politics

Insurers, hospitals, and unions are pushing Congress to spend $100 billion to pay the COBRA insurance payments of 27 million laid-off workers who would basically get their health insurance for free. They are also supporting expanded ACA subsidies and Medicaid, but expect the COBRA bill to gain the widest support in Congress since it bypasses ACA-related politics.

COVID-19

WHO makes a questionable statement that people who are free of COVID-19 symptoms don’t spread the infection, failing to differentiate between “asymptomatic” (infected patients who never experience symptoms) from “pre-symptomatic” (those who are infected but don’t exhibit symptoms until days later). WHO based its conclusion on a tiny review of contact tracing in China, whose findings are not in agreement with four rigorous studies that used actual data instead of people who simply speculate that their infections came from someone with symptoms. The resulting mass media clickbait interpretation makes the definitive statement that people won’t become infected if they avoid those with obvious symptoms, which could affect mitigation strategies such as encouraging social distancing and wearing masks. UPDATE: WHO clarifies that 6-41% of people who are infected don’t have symptoms but can still spread it, with 40% of infections coming from those symptom-free people. WHO says it regrets calling such spread “very rare.” Bottom line: nothing new has been learned and WHO takes a black eye for allowing scientists to confuse the public with poorly worded or researched comments, although they are at least allowing scientists to speak without bureaucratic filters. WHO also said in its correction that nobody should assume that its employees who are speaking at press conferences are speaking on behalf of WHO, which is truly bizarre.

Experts warn that temperature screening of employees and customers provides false reassurance given New York data showing that 70% of people admitted to the hospital for COVID-19 did not have a fever.

Getting people back to work in high-rise office buildings that house thousands of workers creates a new problem with social distancing – limiting the number of people who are allowed in an elevator simultaneously while avoiding having them log-jammed in close proximity in the lobby.

HHS will run out of its free supply of remdesivir by the end of this month as Gilead tries to ramp up production of the antiviral, whose modest benefit to hospitalized COVID-19 patients was enough to convince HHS to distribute it to some hospitals.

Other

Mozilla names the OpenMRS EHR as one of three open source winners of a $50,000 grant from its COVID-19 Solutions Fund. The award will be used to create the OpenMRS Public Health Response system that will include data collection tools, reports, and interfaces with public health systems.

Tuesday saw mixed messages from CMS Administrator Seema Verma on telehealth. She told STAT that “it would not be a good thing to force our beneficiaries to go back to in-person visits,” but then hinted that CMS needs to look at whether it should pay the same rates as in-person visits. She then said in an announcement encouraging the reopening of healthcare facilities that “while telehealth has proven to be a lifeline, nothing can absolutely replace the gold standard: in-person care.” I’m wondering if those who jubilantly predicted that the telehealth genie could not be put back in the bottle may have overestimated, as it seems clear that many providers and patients prefer in-office care; practices are more efficient (and therefore more profitable) when their providers are flitting between multiple exam rooms simultaneously, using non-physician helpers optimally, and perhaps upselling other services; kludgy solutions like Zoom and Skype offer an underwhelming, make-do experience; and the couple of months of virtual-only visits may not have been adequate to permanently change habits. All it would take is a pullback in CMS’s emergency payment and licensure policies to fill the waiting rooms again.

In India, a state government investigates the case of an 80-year-old hospital patient whose family could pay only part of his bill. The hospital, worried about collecting the balance owed, refused to discharged the man and instead tied him to the bed.

Sponsor Updates

• CompuGroup Medical sponsors recognition of Teachers of the Year in its US headquarters in Phoenix. The company provides CGM ELVI for telehealth, which allows teachers and students to connect virtually for counseling and speech therapy sessions.
• Artifact Health engineering VP Jake Lieman describes the company’s experience in integrating its mobile physician query platform with Cerner using Cerner’s APIs.
• Impact Advisors is named to CRN’s 2020 Solution Provider 500 list for the sixth consecutive year.
• Clinical data exchange capabilities from InterSystems helps Nemours Children’s Health System scale its CareConnect telemedicine service.
• XpresSpa will use AdvancedMD’s practice management and EHR software at its new XpresCheck COVID-19 screening and testing facilities in US airports.
• CompuGroup Medical recognizes Teachers of the Year in Phoenix, the home of its US headquarters.
• Elsevier Clinical Solutions adds Portuguese-language content to its COVID-19 Healthcare Hub.
• Ellkay supports the Alpine Learning Group’s virtual Go the Distance for Autism Ride as a platinum sponsor.

Blog Posts

• Improving Financial and Clinical Outcomes During COVID-19 (CareSignal)
• The Importance of Progress Metrics for Epic Go-Live Support (314e)
• Skilled nursing facilities to receive break on reporting staffing data (Ability Network)
• Patient Financial Engagement in a Post-COVID-19 World (AdvancedMD)
• Team up: Xero Viewer & Microsoft Teams Integration for faster COVID-19 Response at PAHT, UK (Agfa Healthcare)
• CMS’ New Hospital Notification Rule: Validation of health information exchange and an opportunity to push further (Audacious Inquiry)
• Interoperability Q&A with Ross Marguiles, Associate at Foley Hoag: Part 1 (CarePort)
• Lessons Learned: Addressing the Pandemic Through Care Collaboration (Collective Medical)
• 10 Years After Diagnosis, Cancer Survivor Focuses on the Future (CoverMyMeds)
• Lessons Learned from Hospital Leaders in the COVID-19 Pandemic (Dimensional Insight)
• 10,000 Daily Pre-Shift Health Checks with Dina’s COVID-19 Screening Tools (Dina)
• Expanding the Range of Specialty Care (EClinicalWorks)
• Telehealth Benefits Expansion: Helping Providers Maximize Reimbursement (Experian Health)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 6/8/20

Top News

A GAO review finds that the VA has implemented effective configuration decision-making in its Cerner implementation by holding national workshops and creating 18 EHR councils, but needs to improve representation at local workshops.

The report also notes that while the VA and DoD both user Cerner, coordination is needed to allow sharing of information and tasks, such as VA’s requirement to maintain durable orders for life-sustaining treatment across patient encounters that is not supported by the DoD’s Cerner configuration.

Reader Comments

From Quinn Martin: “Re: rebranding. Why so hostile to the marketing folks?” That was Dr. Jayne, but I agree with her conclusion. Rebranding is admirable, but publicly pontificating about it and the process that went into it is not. Companies for some reason feel the need to yammer on in press releases about the naively aspirational big-picture ideas that led them to choose a particular website color or logo style (probably just to stroke the marketing people who dreamed it up) and the whole world just rolls its eyes. Just do it and let your audience react without trying to forcibly steer them to pre-conclude how wonderful it all is. My experience is that even though non-marketing company executives grudgingly go along with the process, they aren’t simultaneously committing to implement corporate change as part of the pig-lipsticking process, so it’s usually fluff anyway. Show, don’t tell.

From Creole Mustard: “Re: HIMSS. Pledges to stand against racial inequality.” I will provide a pro bono communication plan for this effort – publicly report how many people of color are on the HIMSS board and executive team, then ask vendor and provider organizations to do the same. I’ll recycle my advice from above – show, don’t tell.

From Didn’t Attend: “Re: HIMSS. Do you agree with Dr. Jayne’s assessment of HIMSS as greedy because they aren’t giving HIMSS20 refunds?” Not exactly. HIMSS was always about profit, highly paid executives, behaving like a vendor, and profitably commingling providers and vendors in a boat show environment that had little to do with patients or actual health. However, it clearly met a market need, as evidenced by its ever-increasing headcount and revenue. My take: I don’t think HIMSS is financially capable of providing HIMSS20 refunds even if it were inclined to do so, especially given the uncertainty of the conference industry in general, from which HIMSS generates $43 million of its $95 million in revenue. Imagine sitting around the HIMSS conference room table trying to plan HIMSS21 amidst the choking dust that remains from the implosion of HIMSS20. Where HIMSS needs to step up is in transparency and honesty instead of brandishing its force majeure clause in the faces of the members and exhibitors who express concerns – those members are really all it has left at this point. HIMSS20 was scheduled for just three months ago, so maybe they are still crafting strategy and exploring options, but I think the wounds are festering rather than healing. Now is the time to win us all back over. Other cancelled conferences seem to be doing a better job of managing the fallout, and while it’s probably unfair to compare leadership styles, I think former CEO Steve Lieber would have taken positive control of the narrative instead of creating a communications void that its critics are happy to fill.

HIStalk Announcements and Requests

More than 80% of poll respondents prefer to work from home at least one day per week.

New poll to your right or here: Would you trust medical research findings that are based on analyzing the EHR data of hundreds of hospitals?

I celebrated the anniversary of the heroics of D-Day, now 76 years in the rear-view mirror, by reading “A Train Near Madgeburg,” a previously untold story of how Americans (mostly teenagers) of the 743rd Tank Battalion, which was one of three tank battalions that landed in the first wave on Omaha Beach, became the world’s first witnesses to the horrors of the Holocaust in April 1945. They rolled into Germany, and purely by serendipity, found and liberated a train full of 2,500 starving concentration camp prisoners who were minutes away from being exterminated to hide evidence of crimes against humanity to the the tune of millions of deaths. The author, a high school teacher, told the stories of those boys of long ago and those mostly women and children they saved, bringing them together in reunions at his school to provide their first-hand accounts. I was uncomfortable with the similarity of those 1933-1945 events to today’s headlines, but I was moved by the actions of one battle-fatigued, eight-man M5 light tank crew who, deep into Nazi Germany and surrounded by mostly hostile locals, were left alone overnight in their single light tank to guard the train’s occupants, who they assured were “under the protection of the United States Army.” Few books capture both the worst and best aspects of humanity like this one and the lessons it contains are worth careful study.

Webinars

June 10 (Wednesday) 1 ET. “COVID-19: preparing your OR for elective surgeries.” Sponsor: Intelligent Medical Objects. Presenters: Janice Kelly, MS, RN, president, AORN Syntegrity Inc.; David Bocanegra, RN, nurse informaticist, IMO. The presenters will cover the steps and guidelines that are needed for hospitals to resume performing elective surgeries and how healthcare information technology can optimize efficiencies and financial outcomes for the return of the OR.

June 18 (Thursday) 12:30 ET. “Understanding the ONC’s Final Rule: Using FHIR HL7 for Successful EHR Integrations.” Sponsor: Newfire Global Partners. Presenters: Bob Salitsky, healthcare IT expert, Newfire Global Partners; Jaya Plmanabhan, MS, healthcare data scientist. This fast-paced, 30-minute webinar will provide an overview of the Final Rule and describe how technology vendors, payers, and providers can use FHIR HL7 to deliver true interoperability. Attendees will learn how to define the data, technology, and flows needed for their EHR integration projects; how products can retrieve health information while meeting compliance regulations; and the benefit of adopting quickly to the future of data exchange while simplifying future integration efforts.

Acquisitions, Funding, Business, and Stock

NorthShore University HealthSystem completes a precision medicine program in which genetic data is loaded into ActX’s genomic service, then is used within Epic to alert medication ordering clinicians of potential genetics-related side effects, efficacy, or dosing considerations. Long-timers know ActX founder and CEO Andy Ury, MD, whose leadership history includes Physician Micro Systems and Practice Partner. In an unrelated note, whose “let’s just make up words” idea led to the grammatical abomination of “NorthShore” and “HealthSystem?” The CEO blabbered on in 2008 about how the former Evanston Northwestern Healthcare had “outgrown its name,” the “NorthShore” part communicates the all-important “prestige,” and the “brand equation” needed to include “University,” all of which were guaranteed to ensure “ushering in a new era.” I’m guessing the locals just call it “North Shore” anyway are are either indifferent to or annoyed by the impersonal “system” in the name.

Announcements and Implementations

Scripps Mercy Hospital San Diego is using Dexcom’s continuous glucose monitoring system for managing inpatient diabetics, including those with COVID-19 who would otherwise require finger sticks.

COVID-19

The government of Delhi, India files charges against a private hospital that failed to report its COVID-19 test results using the government’s mandatory reporting app. The chief minister also issued a warning to hospitals that he says are turning away COVID-19 patients to free up beds to sell on the black market.

US combined deaths for pneumonia, influenza, and COVID-19 as a percentage of the total continue to taper off sharply, on track to return to pre-COVID levels. Total US coronavirus deaths are at 111,000, with the projection that has been most accurate over time predicting 190,000 deaths by September 1.

CMS acknowledges the wide discrepancy between its just-published data on COVID-19 cases in Virginia nursing homes with data from the state’s Department of Health. CMS reports that one nursing home has had 90 residents die of COVID-19 when in fact it has had zero deaths in zero confirmed cases. CMS also reports only nursing home information, while the state includes assisted living centers in its totals. The industry’s trade group says CDC’s slow approval of new accounts explains the 29 facilities that did not report at all. Virginia has refused to provided totals for specific nursing homes since the state defines corporations as “persons” whose confidential information cannot be published.

Sponsor Updates

• Pivot Point Consulting Managing Partner Rachel Marano joins Vaco’s latest Free Yourself podcast, “Flexing to the Curve in Healthcare IT.”
• PerfectServe recognizes customer St. Elizabeth Healthcare as its 2020 Healthcare Champion.
• The Late Late Show host James Corden will keynote Pure Storage’s Pure//Accelerate Digital event on June 10.
• Santa Rosa Consulting publishes a new case study featuring Berkshire Health Systems.
• Spirion welcomes new board members T.E.N. CEO Marci McCarthy and Fannie Mae Deputy General Counsel Jennifer Mailander.

Blog Posts

• A Real View: Supporting Northwell radiologists and the Javits center field hospital with innovation and infrastructure (Nuance)
• Don’t Miss Out on New MTM Opportunities (OmniSys)
• Rapid Radiology puts the focus on senior care (OpenText)
• Wake of the Floor: Enhancing Patient Engagement as we Emerge from the Shutdown (PCare)
• Newborns Don’t Defer Birth: A Clear Case to Better Equip L&D Clinicians (PeriGen)
• Your Future Revealed: Telehealth with PMD (PMD)
• Disrupt or Be Disrupted: Aligning with Independent Physicians Post-Pandemic (Premier)
• HR & Payroll’s Critical Role in Overcoming COVID-19 (ROI Healthcare Solutions)
• Your Workforce Has Changed, So Must Your Identity Strategy (SailPoint)
• 5 strategies to destressing IT teams in stressful times (StayWell)
• COVID-19 Revenue Recovery: Four Steps to Successful Program Launch (Strata Decision Technology)
• The Cost of an EHR Downtime (Summit Healthcare)
• How to Prepare for the Perfect Storm: Hurricane Season and COVID-19 (Surescripts)
• HonorHealth’s AVP Healthcare Marketing on Growth and Loyalty (SymphonyRM)
• End-of-Life Visitation with Safety and Compassion (Vocera)
• Culture After Crisis: How Clinics Must Evolve to Support Employees in the Coming Months (WebPT)
• A Leading Look at Revenue Integrity (Impact Advisors)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 6/5/20

Top News

Governments around the world have changed their COVID-19 policies using apparently flawed research findings from virtually unknown US analytics vendor Surgisphere, whose handful of employees includes a science fiction writer and an adult entertainer.

Lancet has retracted the paper and NEJM has begun the retraction process for hydroxychloroquine-related articles that were based on suspicious data from the company, which is led by founder, CEO, and former vascular surgeon Sapan Desai, MD, PhD.

Surgisphere, which does not identify any scientific advisory board that oversees its work, recently pivoted from publishing medical textbooks. It claims to have created a real-time database of 240 million anonymized patient encounters from 1,200 healthcare organizations in 45 countries, It says the information is provided by “our hospital customers,” although the company declines to name them and no hospitals have come forward as being among those data-providing customers.

Desai says the company has 11 employees. He says it uses AI/ML to perform the data analysis, further explaining, “The labor intensive task required for exporting the data from an electronic health records, converting it into the format required by our data dictionary, and fully de-identifying the data is done by the healthcare partner.”

I found a 2015 paper with Desai as the lead author that used Cerner Health Facts as its data source, so I’m wondering if that’s what Surgisphere uses. I’ve asked Cerner to confirm and am waiting to hear back. I have confirmed that the source is not Epic Cosmos.

As an HIStalk reader says, “This is a major setback for science and the credibility of medical expertise.” I would add that it may also call into question how researchers use aggregated EHR data to draw clinical conclusions when they may not fully understand the semantics and sourcing of that data, especially when most of us know how messy and maddeningly inconsistent EHR data can be even within a single health system, with the potential of AI/ML to introduce further errors while trying to clean it up.

Webinars

June 10 (Wednesday) 1 ET. “COVID-19: preparing your OR for elective surgeries.” Sponsor: Intelligent Medical Objects. Presenters: Janice Kelly, MS, RN, president, AORN Syntegrity Inc.; David Bocanegra, RN, nurse informaticist, IMO. The presenters will cover the steps and guidelines that are needed for hospitals to resume performing elective surgeries and how healthcare information technology can optimize efficiencies and financial outcomes for the return of the OR.

June 18 (Thursday) 12:30 ET. “Understanding the ONC’s Final Rule: Using FHIR HL7 for Successful EHR Integrations.” Sponsor: Newfire Global Partners. Presenters: Bob Salitsky, healthcare IT expert, Newfire Global Partners; Jaya Plmanabhan, MS, healthcare data scientist. This fast-paced, 30-minute webinar will provide an overview of the Final Rule and describe how technology vendors, payers, and providers can use FHIR HL7 to deliver true interoperability. Attendees will learn how to define the data, technology, and flows needed for their EHR integration projects; how products can retrieve health information while meeting compliance regulations; and the benefit of adopting quickly to the future of data exchange while simplifying future integration efforts.

Acquisitions, Funding, Business, and Stock

RCM company R1’s shares jumped over 9% on the news that it will acquire Cerner’s RevWorks business in a transaction valued at $30 million. As part of the deal, Cerner will offer R1’s software and services to customers and prospects. In an April 2019 earnings call, company reps said RevWorks had grown stagnant, contributing $200 million in annual revenue. Cerner had been using its RevWorks offerings “to more tightly align the client to Cerner” for additional sales of its software and services.

Sales

• Cumberland River Hospital (TN) selects RCM software and services from TruBridge, and EHR technology from CPSI sister company Evident.
• CHI Texas Health Network selects Innovaccer’s FHIR Data Activation Platform to help it better manage utilization, care workflows, and patient outreach.

People

Moffitt Cancer Center promotes interim CIO Elizabeth Lindsay-Wood, MBA to the permanent VP/CIO position.

MDLive names Cynthia Zelis, MD (University Hospitals) as chief medical officer.

Intermountain Healthcare hires Ryan Smith, MBA (Health Catalyst) as VP/CIO. He replaces Marc Probst, MBA, who will retire.

AI-powered physician assistant developer Saykara hires Joy Efron (Glytec) as VP of marketing.

Announcements and Implementations

Change Healthcare announces GA of Connected Consumer Health, which includes provider search, appointment scheduling, patient intake, messaging, and billing.

Healthfully adds NextGate’s enterprise master patient index to its white-labeled personal health and wellness record.

Banner Health will use video technology to conduct rounding on patients with COVID-19, repurposing patient room TVs with videoconferencing via virtual care technology from VeeMed and Intel.

Beauregard Health System (LA) implements SOC’s Telemed IQ software for critical care, inpatient neurology, emergency neurology, psychiatry, and cardiology.

Government and Politics

Congressional sources say the VA probably won’t restart its Cerner rollout until the fall because of COVID-19 demands.

A GAO review finds that the “Mar-a-Lago group” of three influential associates of President Trump meddled in the VA’s decision-making as private citizens, including influencing its selection of Cerner, but GAO says it was outside the scope of its investigation to determine whether the group constituted a formal advisory committee whose membership and role carry legal ramifications. Mostly it seems the three — none of whom have any government or military experience — wasted the VA’s time in demanding to become involved, pitching themselves and their associates for various projects, and asking newbie questions using the mandate from the president that left VA officials uncertain about how much effort to spend dealing with them.

HHS provides health systems an additional $250 million to help them expand virtual care and telemedicine services, train staff, procure PPE, and coordinate COVID-19 responses.

COVID-19

HHS issues new COVID-19 testing data requirements that it hopes will give it better understanding of the outbreak. Laboratories must report de-identified COVID-19 testing results to the CDC in one of three ways: (a) through local health departments via HL7 or CSV; (b) by a centralized platform such as AIMS whose information is then routed to CDC; or (c) via an HIE. Required data elements include patient demographics (age, race, ethnicity, sex, ZIP code, and county of residence); provider name and NPI; and date ordered and collected. The same information must be provided for home-based tests. HHS asks (but does not require) that the patient’s name, address, phone number, and date of birth be collected and reported. Also recommended but not mandatory is that the lab results include the test result, unique patient identifier, LOINC-coded test ordered, device identifier, and accession number.  HHS wants to start receiving the new data elements as soon as possible, but no later than August 1.

Morgan Stanley’s COVID-19 model shows a slowly expanding epidemic in the US, with cases and/or hospitalizations rising in Arkansas, Arizona, North Carolina, Washington, Utah, and Texas, leading to its concerns that the US will experience an earlier second wave than other Western nations and will carry a big infection burden into fall as reintroducing mitigation strategies afterward may not be feasible.

Sweden’s top epidemiologist admits that the country’s controversial strategy of avoiding lockdowns to allow mounting a sustained COVID019 response has not been successful, as its 43 deaths per 100,000 population ranks among the worst globally and the country’s economy is slumping anyway.

Premier asks HHS to make 24 temporary, COVID-related regulatory waivers permanent, primarily those involving telehealth. They include allowing non-rural providers to provide services, expanding the types of practitioners, allowing audio-only visits, and expanding telehealth to occupational and behavioral health services. Premier also recommends changing EMTALA to allow pre-admission screening, allowing nurse practitioners and physician assistants to perform routine medical tasks, and eliminating the rule that requires Medicare patients to undergo a three-day inpatient hospital stay before they can be admitted to a skilled nursing facility.

Fitbit secures Emergency Use Authorization from the FDA for its new Fitbit Flow ventilator. The wearables company developed the device with help from the Mass General Brigham Center for COVID Innovation and emergency physicians at Oregon Health & Science University.

A study published in the New England Journal of Medicine finds that hydroxychloroquine did not prevent people who had been exposed to COVID-19 from developing the disease.

Other

A Cleveland Clinic analysis of EHR data finds that while behavioral health ED visits dropped by 28% with the implementation of stay-at-home orders, suicide-related encounters decreased by 60%. The authors don’t know whether the drop-off was due to people not seeking mental health care, using behavioral telehealth services as an alternative, or experiencing fewer suicidal thoughts while isolated. The authors will correlate these findings with actual suicide rates once those are published.

Sponsor Updates

• Wolters Kluwer Health’s customer support teams for UpToDate, Ovid, and Lippincott each win a NorthFace ScoreBoard Award from the Customer Relationship Management Institute.
• Microsoft awards Billings Clinic (MT) and Health Catalyst a joint 2020 Health Innovation Award.
• Health Data Movers publishes a new case study, “COVID-19 Rapid Response.”
• Dina will sponsor the June 18 virtual demo day of Home Health Care News, where it will showcase its COVID-19 employee health screening and reporting tools.
• Hyland donates $10,000 to The Foundation of FirstHealth’s COVID-19 Response Fund.
• KLAS recognizes Impact Advisors with top marks in its Clinical Optimization Services 2020 report.
• Nordic releases a new edition of its HIT Breakdown podcast, “Automating submission of data to registries.”
• CentralLogic publishes a new case study, “Arizona Surge Line: A unique collaborative response to the COVID-19 pandemic and beyond.”
• Bright.md announces that its Smart Exam virtual care technology is now available in Epic’s App Orchard.
• Health Data Movers announces new account managers.
• Health Catalyst will participate virtually in the William Blair Annual Growth Stock Conference on June 10 and the Goldman Sachs Annual Global Healthcare Conference on June 11.

Blog Posts

• How Connected Medical Devices Can Slow COVID-19 Spread in Hospitals (Capsule)
• Coping with COVID-19 – Part 2 (Ingenious Med)
• Single Sign-On vs. MFA: Do You Know the Difference? (Fortified Health Security)
• Maimonides Medical Center Quickly Troubleshoots “Citrix is Slow” Complaints (Goliath Technologies)
• How Google Cloud partners are supporting customers during COVID-19 (Google Cloud)
• Drive-Through COVID-19 Testing Best Practices (Halo Health)
• Virtual Care in Population Health (The HCI Group)
• HITComm – A COVID-19 HIT Solutions Forum (HCTec)
• The Able Health Quality Measures Solution: Why a Comprehensive Approach Matters (Health Catalyst)
• Implementing Prescription Renewal Technology During a Pandemic (Healthfinch)
• Did You Know That the Imat Platform Brings More Meaning to Data Through Natural Language Processing? (Imat Solutions)
• Planning Your Comeback (Impact Advisors)
• Patient-centric and Cost-effective staffing tools designed for Healthcare (Infor)
• The impact of canceling elective procedures due to COVID-19 (Intelligent Medical Objects)
• To Recover After COVID-19, Healthcare Providers Must Advance Tools for Patient Self-Help (Loyale Healthcare)
• How EHRs Help Nurses Balance Care Planning (Medhost)
• What it means to survive cancer, 10 years later (Meditech)
• 7 Biggest Issues Facing Physical Therapists in 2020 (And Tips on Tackling Them) (MWTherapy)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 6/3/20

Top News

Private equity firm Rubicon Technology Partners takes a majority position in patient access center platform vendor Central Logic.

Terms were not announced, but pre-deal rumors suggested a deal value of $110-125 million. The company had previously raised $14 million.

I interviewed President and CEO Angie Franks four months ago.

HIStalk Announcements and Requests

This week marks HIStalk’s 17th birthday. I put together a snapshot of that summer of 2003 last year just to remind long-timers what was happening in the health IT world back then:

• Some big healthcare names were George W. Bush, Tommy Thompson, Tom Scully, Dennis O’Leary, Erich Reinhardt, Linda Kloss, Anthony Principi, and Neal Patterson.
• Hospitals were struggling with early CPOE implementations.
• Kaiser Permanente had just chosen Epic.
• Cerner had just made its first UK sales and opened its new headquarters.
• HIMSS offered HIMSS03 in San Diego (with keynotes from Jeff Immelt, Rudy Giuliani, and Patch Adams) following Summer HIMSS in Chicago and also launched Solutions Toolkit, the predecessor to HIMSS Analytics.
• Computers ran Windows XP while users licked their wounds caused by Windows ME and awaited / dreaded the promised magic of Windows Vista as the effects of the “every other Windows release sucks” rule were about to be felt.
• People sent messages on BlackBerry devices and talked on the Nokia cell phones that dominated the market four years before the IPhone came out.
• Companies such as MercuryMD, Misys, First Consulting Group, Per-Se, IDX, Healthlink, Quovadx, Alaris, and Sentillion were making a few sales.
• Health IT news came slowly and with little critical review other than from expensive, low-circulation newsletters such as “Inside Healthcare Computing” and “HIS Insider.”

Readers whose primary news interest is one or a handful of companies occasionally ask for a separate “news feed” for just those companies. That’s not practical to do since each HIStalk news post contains a lot of unrelated news items to support convenient reading, but this sample page shows the most recent news mentions of Cerner (just as an example) that I’ve copied/pasted into a single page with original dates. It wouldn’t be too hard to keep company-specific pages updated, and the bonus to readers is that instead of just being a bunch of low-quality stuff from around the web, it would just be those stories that I’ve already vetted as being worthy of a news post mention. Let me know if you would find this useful, and if so, for which companies. I won’t bother creating more work for myself if it isn’t important to someone.

Webinars

June 10 (Wednesday) 1 ET. “COVID-19: preparing your OR for elective surgeries.” Sponsor: Intelligent Medical Objects. Presenters: Janice Kelly, MS, RN, president, AORN Syntegrity Inc.; David Bocanegra, RN, nurse informaticist, IMO. The presenters will cover the steps and guidelines that are needed for hospitals to resume performing elective surgeries and how healthcare information technology can optimize efficiencies and financial outcomes for the return of the OR.

Acquisitions, Funding, Business, and Stock

Change Healthcare acquires retail pharmacy technology vendor PDX for $208 million.

Healthcare Growth Partners polls 80 private equity funds about COVID-19’s impact, concluding that those investors are slightly bullish on health IT for the long term compared to the overall market. About 25% of the firms are either pausing activities until the market stabilizes or are waiting to see how COVID-19 plays out, but companies are not generally targeting distressed or discounted opportunities. Many of their portfolio companies are applying for federal relief programs, delaying payables, and seeking additional capital. Most respondents expect a full economic recovery to be unlikely until a COVID-19 vaccine is introduced. All expect to continue closing deals, although half will be looking harder at pricing or strategic value.

NextGen Healthcare reports Q4 results: revenue up 1%, adjusted EPS $0.20 vs. $0.23, swinging to a GAAP loss that fell short of Wall Street expectations but still beating revenue expectations.

Netsmart acquires post-acute and behavioral consulting firm Quality In Real Time, adding the company’s OASIS, MDS, and coding and advisory consulting services to its McBee business.

Konica Minolta Precision Medicine acquires Backpack Health, which offers a personal health record and anonymized research data collection app.

Canada’s Well Health completes its acquisition of Indivica, which serves 1,900 primary care clinics in Canada and represents Well Health’s seventh EHR vendor acquisition.

Allscripts names retired KPMG executive Beth Altman to its board.

Sales

• North Central Health Care (WI) will implement Cerner’s Behavioral Health EHR in three multi-specialty behavioral facilities.
• Northwestern Memorial HealthCare (IL) chooses Visage Imaging’s Visage 7.
• Hospital Sisters Health System will use Empiric Health’s AI-driven analytics to address unwanted clinical variation, mining operative notes with natural language processing to form surgical cohorts to identify outliers.

People

Cerner hires Jerome Labat (Micro Focus) as CTO.

Sandy Phillips (Analytic Intuition) joins HIE Networks as CIO.

Announcements and Implementations

Epic partners with its local county agencies to implement Coordinated Care Management, a technology platform that streamlines healthcare and community services to address social determinants of health. Epic is waiving part of its license and implementation fees.

A study finds that 88% of acute hospitals send information to HIEs at the patient’s transition of care, but only 56% of inpatient psychiatric units provide that information electronically.

Surescripts releases Real-Time Prescription Benefit for Pharmacy, which allows pharmacists to advise patients on out-of-pocket costs and alternatives using pricing, coverage, and prior authorization information from the patient’s insurance.

COVID-19

CMS reports that COVID-19 has hit US nursing homes hard, with the first publicly announced count (which is likely underestimated) count showing 60,000 confirmed cases and 26,000 deaths, with 450 staff members also dying of the infection. Meanwhile, USA Today analysis of state-reported data that, unlike CMS’s numbers, includes assisted living facilities places the number of deaths at nearly 41,000.

A WHO-conducted meta analysis of 172 studies confirms that frontline medical workers should be wearing N95 masks, which offer 96% protection against coronavirus versus 77% for surgical masks. Eye protection appears to offer additional benefit. For public spaces, distancing of at least three feet and wearing of cotton masks were associated with protection. Experts are frustrated CDC was slow to recommend masks and later downgraded its recommendation of N95 masks to surgical masks on the basis of supply rather than effectiveness.

A China-based manufacturer of N95 masks misses a deadline for earning US federal safety certification, voiding its $1 billion deal with the state of California for which it has already been paid $495 million. The company was supposed to provide 300 million masks, but NIOSH turned down its certification due to “concerning” issues with its design, manufacturing, and quality inspection. Electric vehicle manufacturer Build Your Dreams opened a plant in China in March that it said would allow manufacturing 5 million masks and 300,000 bottles of disinfectant per day, leading to a deal with the state that critics called “secretive.”

Experts remind that temperature checks aren’t very useful for COVID-19 screening since most patients who test positive don’t have fever, especially before they start showing symptoms.

White House coronavirus testing czar Admiral Brett Giroir has been reassigned back to his regular HHS job as of mid-June and will not be replaced.

The state of Nevada contracts for COVID-19 testing from G42, an artificial intelligence company whose ToTok messaging app is used to spy on civilians in the United Arab Emirates. University Medical Center is performing tests provided by G42 and is considering using its product for population health management and genomics studies. ToTok became popular in UAE because the country bans Internet calls and the app provides a seemingly government-approved way to conduct video and text chat, which security experts say is the government’s covert way of getting users to install spyware voluntarily instead of hacking their phones.

Sponsor Updates

• Collective Medical end users can now sponsor home health organizations to rapidly onboard and begin collaborating on care for shared patients.
• Impact Advisors is recognized in KLAS’s }Clinical Optimization Services 2020” report.

Blog Posts

• Social Determinants of Health Amidst a Pandemic (Collective Medical)
• 3 Advantages of EHR Digital Learning for Large Health Systems (314e)
• How to tell nurses they can’t have the day off (Ability Network)
• Total Telehealth & The Grant to Pay for It Now (Access)
• Medical practice cybersecurity: 4 Sure Ways to Stop Cyber Thieves (AdvancedMD)
• How De-Identified Patient Data Fuels COVID-19 Research (ChartLogic)
• Why Now is a Good Time to Shift Your Focus (Culbert Healthcare Solutions)
• Dina’s COVID-19 Employee Screening Solutions Are Live in 20 States (Dina)
• Reinventing Your Practice During Extreme Times (EClinicalWorks)
• What Does the “New Normal” Look Like for Acute Care? (Ensocare)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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